A new study published in the American Journal of Obstetrics & Gynecology suggests that preconception care for diabetic women could save an estimated $5.5 billion in health expenditures and lost employment productivity over the lifetimes of affected children.

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“The preconception period is critical for preventing adverse birth outcomes in women with PGDM,” comments lead investigator Cora Peterson.

Preterm deliveries, birth defects and perinatal deaths are significant complications that have been linked with diabetes in pregnant women.

In the new study, health economists and researchers from the Centers for Disease Control and Prevention (CDC) examined to what extent preconception care (PCC) might help avoid adverse birth outcomes and generate savings to health care payers and society.

The study estimates that 2.2% of all births in the US are to women with pre-existing diabetes or pregestational diabetes mellitus (PGDM), although not all of these women will yet have been diagnosed with diabetes.

“The preconception period is critical for preventing adverse birth outcomes in women with PGDM,” comments lead investigator Cora Peterson, PhD, from the CDC’s National Center for Injury Prevention and Control. “By some estimates, nearly half of US pregnancies, including pregnancies among women with PGDM, are unplanned.”

“To prevent adverse birth outcomes among women with undiagnosed diabetes, diagnosis in the preconception period is needed,” she adds. “The first step would be screening women of reproductive age to identify those with undiagnosed diabetes.”

The researchers estimate that, in terms of adverse outcomes, PCC might annually avert:

  • 8,397 preterm deliveries
  • 3,725 birth defects
  • 1,872 perinatal deaths.

In terms of savings, the study reports that $4.3 billion in costs and lost employment productivity over the lifetimes of affected children might be saved by PCC among diabetic women. In addition, PCC among women with undiagnosed diabetes could potentially save a further $1.2 billion, say the researchers.

Cora Peterson explains the team’s findings:

We estimated thousands of adverse birth outcomes might be prevented each year among US women with PGDM through universal PCC at an estimated lifetime societal cost savings of up to $5.5 billion, including nearly $1 billion in direct medical costs.

Our results suggest a substantial health and cost burden associated with PGDM that could be prevented by universal PCC, which might offset the cost of providing such care.”

The assessments in the study are based on the assumption that PCC would be widely available and fully utilized by women. However, Peterson admits “It is possible that lack of insurance coverage might disproportionately affect women with both unintended pregnancies and undiagnosed PGDM, creating a substantial cost barrier to PCC for [eligible] women.”

Access to affordable health care and insurance remains a challenge for many women in the US, the researchers note.

In a linked comment, Prof. Kim Boggess, of the Division of Maternal Fetal Medicine at the UNC School of Medicine, writes:

“While PCC for women with PGDM can avert adverse outcomes and save money, what should the content of this care be and how do we provide it for all women? Who pays for it? Despite these limitations, the results [of this study] suggest that the PCC-preventable health and cost burdens associated with PGDM are substantial.”

Recently, Medical News Today reported on a study published in the BMJ that found quitting smoking, eating healthily, exercising regularly and maintaining a healthy weight prevents nearly half of gestational diabetes cases.