A wide variety of conditions can be associated with or aggravated by pregnancy, childbirth and puerperium (the period following childbirth where the reproductive organs return to their pre-pregnant state). Factors such as age, obesity, lifestyle, and diet can affect the risk of developing some of these conditions. Their management is associated with significant healthcare costs and can lead to maternal and foetal death.
The aim of this study is to describe, over time, the number of people who experience conditions related to or aggravated by pregnancy, childbirth and the puerperium in the UK and estimate the healthcare costs associated with managing these conditions. How often a disease occurs in our population plays an important role in planning NHS services and highlighting areas for future research and development.
Research-quality patients that have experienced a condition related to or aggravated by pregnancy, childbirth and the puerperium will be selected. The number of people developing the condition (its incidence) will then be calculated on a yearly basis for the duration of the data source, and the proportion of people having that condition at the midyear point (its point prevalence) will be calculated over the same period. Time to death and patients’ characteristics will be presented. The frequency and cost of primary care consultations, prescriptions, outpatient attendances and inpatient stays will also be determined.
We aim to determine the descriptive epidemiology of conditions listed in ICD-10 chapter XV Pregnancy, childbirth and the puerperium and estimate and cost healthcare use for people with these conditions. Acceptable patients will be selected from the Clinical Practice Research Datalink (CPRD) GOLD and Aurum datasets if they have a medical code indicative of a relevant condition. For sensitivity analyses, a subcohort will comprise English patients eligible for linkage to the HES admitted patient care (APC) and outpatient datasets, and their Office for National Statistics (ONS) death registration data. The start of CPRD follow-up will be defined as the later of the patient’s registration date and, in CPRD GOLD, their practice’s up-to-standard date; the end of CPRD data follow-up will be defined as the earliest of the patient’s transfer-out date, date of death (if applicable), and the last data-collection date for their practice. The presentation date will be defined as that of the patient’s first ever record with a code indicative of a relevant condition. Incident patients will be selected if their presentation date occurs at least 90 days after registration. Time to death will be presented using Kaplan–Meier analysis. Healthcare resource use and costs will be estimated before and after presentation. Healthcare resource use and costs will be compared with a non-exposed control group of acceptable, HES eligible patients matched in a 1:1 ratio on age, sex, registration status at the date of the case’s start of follow-up and general practice using the independent t-test or Mann–Whitney U test depending on the distribution. Quintiles of deprivation score will be described. Incidence and point prevalence will be calculated on a yearly basis.
This study will provide valuable information on the healthcare burden of conditions associated with or aggravated by pregnancy, childbirth, and the puerperium and help to inform healthcare decision-making.
Patient characteristics; Comorbidities; Healthcare resource use; Healthcare costs; All-cause mortality; Cause-specific mortality; Incidence; Prevalence
Craig Currie - Chief Investigator - Pharmatelligence Limited t/a Human Data Sciences
Sarah Holden - Corresponding Applicant - Pharmatelligence Limited t/a Human Data Sciences
Benjamin Heywood - Collaborator - Pharmatelligence Limited t/a Human Data Sciences
Bethan Jones - Collaborator - Pharmatelligence Limited t/a Human Data Sciences
Chris Shepherd - Collaborator - Pharmatelligence Limited t/a Human Data Sciences
Christian Bannister - Collaborator - Pharmatelligence Limited t/a Human Data Sciences
Christopher Morgan - Collaborator - Pharmatelligence Limited t/a Human Data Sciences
Darren Summers - Collaborator - Pharmatelligence Limited t/a Human Data Sciences
Elgan Mathias - Collaborator - Pharmatelligence Limited t/a Human Data Sciences
Ellen Hubbuck - Collaborator - Pharmatelligence Limited t/a Human Data Sciences
James Bateman - Collaborator - Pharmatelligence Limited t/a Human Data Sciences
Rhiannon Thomason - Collaborator - Pharmatelligence Limited t/a Human Data Sciences
Sara Jenkins-Jones - Collaborator - Pharmatelligence Limited t/a Human Data Sciences
Thomas Berni - Collaborator - Pharmatelligence Limited t/a Human Data Sciences
HES Admitted Patient Care;HES Outpatient;ONS Death Registration Data;Practice Level Index of Multiple Deprivation