Relatively little is known about the longer term economic impacts of smoking during pregnancy. Children born to mothers who smoke have worse birth outcomes, such as increased infant mortality and birth defects, and are therefore hypothesised to incur greater healthcare costs than children of non-smoking mothers.
The overall objective of this study is to investigate the impact of smoking in pregnancy on infants’ and children’s use of healthcare resources. We will investigate whether or not mothers’ smoking behaviour in pregnancy and after pregnancy results in higher levels of healthcare use for their infants or children. We will quantify the costs of delivering healthcare to children and infants and will investigate how these vary with maternal smoking behaviour in pregnancy and the postpartum period. Information on the costs of children’s and infants’ healthcare will be used to inform an economic model of smoking in pregnancy.
The objective of this study is to use Hospital Episode Statistic (HES)-linked Clinical Practice Research Datalink (CPRD) data to provide descriptive statistics for the number of primary and secondary care consultations experienced by infants and children of pregnant women who are smokers and non-smokers. Means and standard deviations will be produced to describe the overall number of primary and secondary care consultations. Furthermore, this study also aims to test whether or not overall healthcare utilisation varies with smoking behaviour in pregnancy. Poisson regression will be used to provide rate ratios and 95% confidence intervals (CI) for healthcare consultation rates. Generalised estimating equations will be used to cluster by mother, for women who have had more than one child during the follow-up period. The costs of delivering primary and secondary care consultations will be calculated using standard reference sources and appropriate, smoking-attributable costs of healthcare utilisation will be used within the Economic model of Smoking In Pregnancy (ESIP) to improve the accuracy of model estimates.
Lisa Szatkowski - Chief Investigator - University of Nottingham
Timothy Coleman - Corresponding Applicant - University of Nottingham
Laila Tata - Collaborator - University of Nottingham
Luis Vaz - Collaborator - University of Nottingham
Matthew Jones - Collaborator - University of Nottingham
Stavros Petrou - Collaborator - University of Warwick
CPRD Mother-Baby Link;HES Admitted Patient Care;HES Outpatient;ONS Death Registration Data;Patient Level Index of Multiple Deprivation;Patient Level Townsend Score;Practice Level Index of Multiple Deprivation