Incremental charges, costs, and length of stay associated with obesity as a secondary diagnosis among pregnant women

Leonardo Trasande, Menjean Lee, Yinghua Liu, Michael Weitzman, David Savitz

Research output: Contribution to journalArticlepeer-review


BACKGROUND:: Elevation in prepregnancy body mass index (BMI) has been linked to a host of perinatal complications, but increases in charges or costs associated with obesity during pregnancy have not been quantified. METHODS:: To evaluate the economic impact of obesity as a diagnosis on hospitalizations of pregnant women, we performed descriptive, univariate, and multivariable analysis of the 1999 to 2005 Nationwide Inpatient Sample, a nationally representative sample of admissions to US community hospitals. RESULTS:: Hospitalizations with a diagnosis of obesity were rare (0.7%), but when obesity was a diagnosis, it was associated with significant increases in length of stay (LOS), charges, and costs. Cesarean section was more frequent among women hospitalized with a diagnosis of obesity, with increases in this procedure across nearly every pregnancy-related diagnostic category. Controlled for cesarean section, diagnosed obesity was associated with significant increases in LOS (0.55 day), charges ($2015), and costs ($1805). Increases in LOS were sustained across nearly every diagnostic category when cesarean section was incorporated into the modeling, whereas increased cesarean section explained increases in costs for hemorrhage during pregnancy and abnormal glucose tolerance during pregnancy. DISCUSSION:: Although these hospitalizations represent a relatively small sample of all obese pregnant women, diagnosed obesity seems to contribute heavily to increased costs among pregnant women. Further studies are needed to identify reasons increased health care costs of caring for women with obesity during pregnancy besides increased cesarean section. These data may encourage insurers to provide fiscal incentives to prevent complications of obesity during pregnancy.

Original languageEnglish (US)
Pages (from-to)1046-1052
Number of pages7
JournalMedical care
Issue number10
StatePublished - Oct 2009


  • Economic analysis
  • Hospitalization charges
  • Obesity
  • Pregnancy complications

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health


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