OBJECTIVES : Preeclampsia is associated with significant perinatal mortality. This study’s objective was to evaluate the impact of maternal preeclampsia on clinical outcomes and healthcare expenditures among a cohort of infants linked to their mothers utilizing insurance claims data.

METHODS : Women aged 15-50 with evidence of a singleton delivery between 1/1/2010 and 9/30/2015 and at least 12 months of continuous enrollment before and after the delivery date were identified in the MarketScan Commercial Databases. Infants were linked to their mothers and required to be continuously enrolled for 12 months following their birth date. Maternal preeclampsia was identified if a diagnosis of preeclampsia was present during the pregnancy and prior to delivery. Infant clinical outcomes and expenditures were assessed using medical claims in the 12 months following birth and compared based on presence of maternal preeclampsia.

RESULTS : 557,481 linked mother:infant pairs were identified; 10,371 (1.9%) with maternal preeclampsia. Rates of cesarean section (55.9% vs. 36.6%), preterm delivery (15.3% vs. 5.4%), low birth weight (18.9% vs. 5.0%), and feeding problems (38.3% vs. 32.3%) were significantly higher in infants with maternal preeclampsia (p<0.001 for all). Infant all-cause total health care expenditures ($34,034 vs. $15,067) and inpatient ($28,295 vs. $10,383) costs in the first year of life were significantly higher in infants with maternal preeclampsia; outpatient ($5,739 vs. $4,426) and pharmacy costs ($436 vs. $258) were also significantly higher (p<0.001 for all).

CONCLUSIONS : It is feasible to link mothers with their newborn infants to evaluate health outcomes and healthcare expenditures in infants based on maternal comorbidities. Healthcare expenditures for all types of healthcare resource use were significantly higher in the first year of life in infants with maternal preeclampsia and these differences are likely attributable to the increased rate of preterm delivery and low birth weight in infants with maternal preeclampsia.