PRODUCTIVITY LOSSES AFTER MISCARRIAGE: A PROSPECTIVE COHORT ANALYSIS USING THE IMTA PRODUCTIVITY COST QUESTIONNAIRE
Author(s)
Corneliu Bolbocean, PhD;
University of Oxford, Senior Researcher, Oxford, United Kingdom
University of Oxford, Senior Researcher, Oxford, United Kingdom
OBJECTIVES: Estimate work-productivity losses (absenteeism, presenteeism, unpaid work) after miscarriage using the iMTA Productivity Cost Questionnaire (iPCQ) and value them from a societal perspective with the human capital approach (HCA); assess whether losses differ by number of miscarriages (1, 2, ≥3).
METHODS: We conducted a prospective cohort of women with clinically confirmed miscarriage at a Birmingham NHS Trust, United Kingdom. Assessments occurred at 6 weeks (baseline), 3, 6, and 12 months post miscarriage. Productivity losses were measured with the iPCQ and valued in 2024 GBP. We report means with participant-level cluster bootstrap 95% CIs (2,000 resamples) and describe distributions using wave-specific intercept-only two-part modelsPrimary endpoint: societal HCA cost per person. Absenteism and unpaid work outcomes were analysed with two-way fixed-effects models (TWFE).
RESULTS: Mean societal HCA costs per person over 4 week time samples were £578 (95% CI £432-£724) at 6 weeks (n=203), £554 (£389-£719) at 3 months (n=143), £506 (£321-£690) at 6 months (n=108), and £585 (£435-£735) at 12 months (n=182). Using a human capital framework and person-specific denominators, we found that average societal productivity costs per four-week window were substantial and persistent across the year following index participation, with means of pounds 506-pounds 585. Paid work losses accounted for 93% of the societal total; mean unpaid replacement costs were £25-£28. Hours lost were dominated by absenteeism (18.7-21.7 hours) over presenteeism (2.4-2.8 hours). The proportion of women who incurred any productivity-loss costs was 44-48% across waves. Participants with ≥3 miscarriages had persistently higher probabilities of adverse productivity-related outcomes at 3-12 months.
CONCLUSIONS: Miscarriage is associated with substantial productivity losses primarily driven by absenteeism. Losses are larger and more persistent among women with recurrent miscarriage (≥3). These findings support stratified post miscarriage supports and potential value of workplace accommodations particularly for women with recurrent miscarriage.
METHODS: We conducted a prospective cohort of women with clinically confirmed miscarriage at a Birmingham NHS Trust, United Kingdom. Assessments occurred at 6 weeks (baseline), 3, 6, and 12 months post miscarriage. Productivity losses were measured with the iPCQ and valued in 2024 GBP. We report means with participant-level cluster bootstrap 95% CIs (2,000 resamples) and describe distributions using wave-specific intercept-only two-part modelsPrimary endpoint: societal HCA cost per person. Absenteism and unpaid work outcomes were analysed with two-way fixed-effects models (TWFE).
RESULTS: Mean societal HCA costs per person over 4 week time samples were £578 (95% CI £432-£724) at 6 weeks (n=203), £554 (£389-£719) at 3 months (n=143), £506 (£321-£690) at 6 months (n=108), and £585 (£435-£735) at 12 months (n=182). Using a human capital framework and person-specific denominators, we found that average societal productivity costs per four-week window were substantial and persistent across the year following index participation, with means of pounds 506-pounds 585. Paid work losses accounted for 93% of the societal total; mean unpaid replacement costs were £25-£28. Hours lost were dominated by absenteeism (18.7-21.7 hours) over presenteeism (2.4-2.8 hours). The proportion of women who incurred any productivity-loss costs was 44-48% across waves. Participants with ≥3 miscarriages had persistently higher probabilities of adverse productivity-related outcomes at 3-12 months.
CONCLUSIONS: Miscarriage is associated with substantial productivity losses primarily driven by absenteeism. Losses are larger and more persistent among women with recurrent miscarriage (≥3). These findings support stratified post miscarriage supports and potential value of workplace accommodations particularly for women with recurrent miscarriage.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
EE26
Topic
Economic Evaluation
Topic Subcategory
Work & Home Productivity - Indirect Costs
Disease
STA: Multiple/Other Specialized Treatments