Post–Delivery Hospital Charges in Women With/Without Periodontal Disease

Objectives: Periodontal disease is considered a risk factor for poor pregnancy outcomes. We tested the hypothesis that women with poor pregnancy outcomes who also had periodontal disease incurred higher post-delivery hospital charges compared to women with poor pregnancy outcomes, but no periodontal disease or the women with normal pregnancy outcomes irrespective of their periodontal status.
Methods: In a prospective follow-up study of 265 women from Bellevue Hospital Prenatal Clinic in New York City, the association between clinical, bacteriological, and immunological parameters related to maternal periodontal disease and initial hospital charges was evaluated. Initial hospitalization was defined as an admission which resulted in a birth (live or otherwise).

Results: Subjects were predominantly Hispanic (83%), White (84%), and relatively young (mean age 26.8 years; SD = 5.8). Twenty-seven percent of subjects had clinical periodontal disease and 10% delivered preterm babies. On average, mothers who delivered preterm babies incurred significantly higher maternal, infant, and total charges and their babies stayed in the hospital for a longer duration (p <0.05). Women with poor pregnancy outcomes and periodontal disease stayed in the hospital for 3.4 days (SD = 2.49) on average after delivery and incurred $10,112.36 (SD = 6,834.06) as average charges compared to 2.61 days (SD = 0.75) and $7,387.55 (SD = 2,107.85) by women who had normal pregnancy outcomes and no periodontal disease (p=0.027), after controlling for potential confounders. Interestingly, women with higher IgG against Aggregatibacter actinomycetemcomitans also had significantly higher maternal, infant, and total charges as well as longer maternal and infant stay in the hospital after delivery.
Conclusions: Women who experienced poor pregnancy outcomes who also had periodontal disease tend to stay in the hospital longer after delivery and may incurr higher post-delivery hospital charges.