OBJECTIVES:

Understanding the association between an individual’s lost work time and preterm birth (PTB) will inform employers of the value of prolonging pregnancy in at-risk individuals. This is the first comparative study to estimate workplace productivity loss (WPL) associated with PTB in the United States.

METHODS: Data for individuals delivering a live birth at ≥23 weeks gestational age (wGA) (index date) were extracted from MarketScan Commercial claims (January 2016–September 2021). Inclusion criteria were: age 18–55 years, primary insurance beneficiary, and continuous enrollment ≥6 months pre- and ≥12 months post-index. Individuals were divided into two clinically-relevant cohorts: PTB (<37 wGA) and full-term birth (FTB) (≥37 wGA) that were propensity-score matched on pre-specified baseline covariates separately for each endpoint: medically-related absenteeism (emergency or inpatient [1 day] or outpatient [0.5 day] visit), workplace absenteeism (sick, vacation, recreational leave; Family Medical Leave Act [FMLA]), disability (short- and long-term), and overall WPL. Per-patient workdays lost in the year following delivery are reported.

RESULTS:

At baseline, the cohorts for medically-related absenteeism (n=37,522), workplace absenteeism (n=1,028), disability (n=7,880), and overall WPL (n=396) were well matched. The main analysis showed PTB was associated with significantly more workdays lost due to medically-related absenteeism (4.2 days) and disability (2.8 days) than FTB (both p<0.001); a sensitivity analysis (based on a conservative definition of workplace absenteeism: sick leave and FMLA) showed PTB was associated with significantly more workdays lost due to overall WPL than FTB (5.7 days; p=0.012). Subgroup analyses showed early PTB (<34 wGA or <32 wGA) was associated with more workdays lost due to medically-related absenteeism (8.5 or 10.5 days, respectively) and overall WPL (8.1 or 14.1 days, respectively) than FTB. Other differences, although in the expected direction, were not statistically significant.

CONCLUSIONS:

PTB was associated with notable WPL in the year following delivery compared to FTB.