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Pregnancy outcomes of women with MS in a large US claims database
Author(s): ,
M.K Houtchens
Affiliations:
Brigham and Women's Hospital, Harvard Medical School, Brookline
,
N.C Edwards
Affiliations:
Health Services Consulting Corporation, Boxborough
,
J Aggarwal
Affiliations:
Boston Health Economics, Inc., Waltham
A.L Phillips
Affiliations:
EMD Serono, Inc., Rockland, MA, United States
ECTRIMS Online Library. Houtchens M.
Sep 16, 2016; 146704
Maria K. Houtchens
Maria K. Houtchens
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Abstract: P864

Type: Poster

Abstract Category: Clinical aspects of MS - MS and gender

Introduction: Multiple sclerosis (MS) affects women three times more commonly than men, and the clinical onset is often during childbearing years. Although healthcare claims data are collected for administrative rather than research purposes, they can provide insight into outcomes of women with MS and pregnancy in a real-world population. This study aimed to evaluate pregnancy outcomes of women with MS in a large US claims database.

Methods: This was a retrospective analysis of women aged 18-65 years with MS (International Classification of Diseases, Ninth Revision, Clinical Modification code: 340.xx), a pregnancy-related claim (diagnosis code or procedure), and 1 year continuous eligibility pre- and post-pregnancy claim from the IMS Health Real World Data Adjudicated Claims - US database (from 1/1/2006-30/6/2015). Pregnancy outcomes evaluated were: indication of a live birth; complications during pregnancy, labour and delivery, and the puerperium period; ectopic and molar pregnancies; and other abortive outcomes.

Results: A total of 205,466 women with MS were included; 10,630 had a pregnancy claim. Of those, 5022 had 1 year of continuous eligibility pre- and post- pregnancy claim. The mean (standard deviation [SD]) age of women with a pregnancy claim who met the eligibility criteria was 34.3 (8.1) years. Most patients had commercial health insurance (98.1%) and were from the Northeast (32.2%), Midwest (29.9%), or South regions (29.2%) of the US. The mean (SD) Charlson Comorbidity Index score was 0.35 (0.89) pre- and 0.34 (0.87) post-pregnancy claim. Common comorbidities included gastrointestinal disorders (17.6%), depression (14.4%), thyroid disease (14.1%), hypertension (13.5%), anxiety (12.3%), and hyperlipidaemia (10.5%). Over half had a live birth (n=2867; 57.1%). The proportions of women with claims for complications during pregnancy were: diabetes/abnormal glucose test, 12.0%; infection, 8.5%; mental health disorders, 5.0%; hyperemesis gravidarum/vomiting, 5.2%; thyroid disease, 4.2%; pre-eclampsia/eclampsia, 4.2%; and placental problems, 4.0%. The proportions of women with claims during labour and delivery were: malposition/disproportion, 31.9%; forceps/C-section, 8.5%; and haemorrhage, 8.0%. The proportion of women with claims for ectopic and molar pregnancy was 13.0% and for other pregnancy with abortive outcomes was 14.7%.

Conclusions:
This study presents pregnancy outcomes of women with MS from a large US administrative claims database.

Disclosure: Maria K Houtchens received grant support from EMD Serono, Inc.

Natalie C Edwards
is an employee of Health Services Consulting Corporation. Health Services Consulting Corporation received funding from EMD Serono, Inc., to run the analysis.

Jyoti Aggarwal
is an employee of Boston Health Economics, Inc. (BHE). BHE received consulting fees from EMD Serono, Inc.

Amy L Phillips is an employee of EMD Serono, Inc., Rockland, MA, USA (a business of Merck KGaA, Darmstadt, Germany).

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