Signs or Symptoms of Suspected Preeclampsia – a Retrospective National Database Study of Prevalence, Costs, and Outcomes

Authors

• Kavia Khosla
• Yue Jin
• Jimmy Espinoza
• Matthew Kent
• Mikael Gencay
• Liza H Kunz
• Ariel Mueller
• Yan Xiao
• W Frank Peacock
• Sean-Xavier Neath
• Jennifer J Stuart
• Douglas Woelkers
• James M Harris
• Sarosh Rana

Language

English

Publication Date

6-1-2024

Journal

Pregnancy Hypertension

DOI

10.1016/j.preghy.2024.101124

PMID

38608393

Abstract

Background: Most patients with signs or symptoms (s/s) of suspected preeclampsia are not diagnosed with preeclampsia. We sought to determine and compare the prevalence of s/s, pregnancy outcomes, and costs between patients with and without diagnosed preeclampsia.

Methods: This retrospective cohort study analyzed a large insurance research database. Pregnancies with s/s of preeclampsia versus a confirmed preeclampsia diagnosis were identified using International Classification of Diseases codes. S/s include hypertension, proteinuria, headache, visual symptoms, edema, abdominal pain, and nausea/vomiting. Pregnancies were classed as 1) s/s of preeclampsia without a confirmed preeclampsia diagnosis (suspicion only), 2) s/s with a confirmed diagnosis (preeclampsia with suspicion), 3) diagnosed preeclampsia without s/s recorded (preeclampsia only), and 4) no s/s, nor preeclampsia diagnosis (control).

Results: Of 1,324,424 pregnancies, 29.2 % had ≥1 documented s/s of suspected preeclampsia, and 14.2 % received a preeclampsia diagnosis. Hypertension and headache were the most common s/s, leading 20.2 % and 9.2 % pregnancies developed to preeclampsia diagnosis, respectively. Preeclampsia, with or without suspicion, had the highest rates of hypertension-related severe maternal morbidity (HR [95 % CI]: 3.0 [2.7, 3.2] and 3.6 [3.3, 4.0], respectively) versus controls. A similar trend was seen in neonatal outcomes such as preterm delivery and low birth weight. Cases in which preeclampsia was suspected but not confirmed had the highest average total maternal care costs ($6096 [95 % CI: 602, 6170] over control).

Conclusion: There is a high prevalence but poor selectivity of traditional s/s of preeclampsia, highlighting a clinical need for improved screening method and cost-effectiveness disease management.

Keywords

Humans, Female, Pregnancy, Pre-Eclampsia, Retrospective Studies, Adult, Prevalence, Databases, Factual, Pregnancy Outcome, Young Adult, United States, Health Care Costs, Diagnosis, Evaluation, Healthcare costs, Healthcare outcomes, Preeclampsia, Risk stratification

Published Open-Access

yes

Recommended Citation

Khosla, Kavia; Jin, Yue; Espinoza, Jimmy; et al., "Signs or Symptoms of Suspected Preeclampsia – a Retrospective National Database Study of Prevalence, Costs, and Outcomes" (2024). Faculty, Staff and Student Publications. 3879.
https://digitalcommons.library.tmc.edu/uthmed_docs/3879