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Obesity During Pregnancy Carries Bigger Price Tag

Study finds the extra health-care costs strain the system

WEDNESDAY, April 2 (HealthDay News) -- It is well-known that obesity increases the chances of medical complications during pregnancy, but now a new study shows it also puts a financial strain on the health-care system.

Obese women who are pregnant tend to have longer hospital stays, require more medications, and spend more time with their doctors than normal-weight women do. Much of this is due to complications such as high blood pressure, preeclampsia and Caesarean deliveries, researchers find.

"Right now, about one in five women in the United States who deliver babies are obese," said lead researcher Susan Y. Chu, a senior epidemiologist at the U.S. Centers for Disease Control and Prevention. "Given that there are about 4 million births in the United States each year, that translates to almost 1 million obese women giving birth."

"Obesity during pregnancy is associated with more use of health-care services," Chu said. "Even if there is a small increase, it is going to have substantial financial implications."

The report is published in the April 3 edition of the New England Journal of Medicine.

In the study, Chu's team collected data on 13,442 pregnancies that occurred from 2000 to 2004. These births were recorded by a large managed-care system. The researchers looked at the relationship between obesity and the use of health-care services before and during pregnancy.

Chu's group found that obese women have significantly longer hospital stays compared with normal-weight women. For most obese women, a hospital stay was 4.1 days longer than it was for normal-weight women.

The increased hospital stays were mostly related to more Caesarean deliveries among obese women than normal-weight women, Chu said.

In addition, obese women required more prenatal tests, more ultrasound examinations and more medications than normal-weight women. Obese women also made more phone calls to their doctors and had more physician visits than normal-weight women, the researchers found.

While obese women used more medical services during pregnancy, they were less likely to see nurse practitioners and physicians assistants for prenatal care, Chu's team found.

One expert says that obesity takes both a health and a financial toll on pregnant women.

"This article accurately reflects the well-known fact that obesity is a significant risk factor in pregnancy," said Dr. Richard Frieder, an obstetrician-gynecologist at Santa Monica-UCLA Medical Center.

"This wasn't a problem 50 years ago, before the fast food/super-size generation that is now having babies," Frieder added.

Complications such as preeclampsia, diabetes, deep vein thrombosis, macrosomia (excessive newborn birth weight), abnormal labor and the need for a Caesarean delivery are the usual reasons for an increased level of care and longer hospital stays, Frieder said.

"This is all just a small example of the massive problem that obesity costs our society, both to individual health as well as the economic cost to our institutions," Frieder said.

More information

For more on obesity, visit the U.S. National Institutes of Health.

SOURCES: Susan Y. Chu, Ph.D., senior epidemiologist, U.S. Centers for Disease Control and Prevention, Atlanta; Richard Frieder, M.D., obstetrician-gynecologist, Santa Monica-UCLA Medical Center, and clinical instructor, obstetrics and gynecology, David Geffen School of Medicine, University of California, Los Angeles; April 3, 2008, New England Journal of Medicine

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