Economic costs associated with miscarriage: A secondary analysis of QResearch

Miscarriage is defined as the loss of pregnancy before the fetus reaches viability and is the most common complication of pregnancy affecting as many as 15–25% of pregnancies. There are approximately 200,000 miscarriages per year in the UK. Most miscarriages are sporadic in nature, but approximately 5% of women experience recurrent miscarriage with adverse consequences for their psychological well-being and future reproductive potential.

Despite a growing evidence base about the clinical, reproductive and psychological consequences of miscarriage, relatively little is known about the economic consequences of miscarriage or the cost-effectiveness of interventions or strategies aimed at its prevention or management.

This study aims to estimate the economic costs associated with sporadic and recurrent miscarriage using data within the QResearch database, a large primary care database linked to Hospital Episode Statistics admitted patient care and outpatient data. Cumulative healthcare service use and costs covering primary and secondary health care services over three months, one year and five years of follow-up will be estimated for a study group identified as experiencing a miscarriage and two control groups, the first a control group of women with viable pregnancies matched to cases by gestational age upon study entry, and the second a control group of non-pregnant women matched for the woman's age upon study entry.

Inverse probability weighted generalised estimating equations will be used to model non-linear trends in healthcare service use and costs over time, accounting for missing data, and adjusting for year of study entry, maternal age, previous pregnancy history, body mass index, maternal medical conditions, thrombophilia’s, and lifestyle factors such as smoking. It is anticipated that the study will generate a compendium of economic variables and values that are transportable to future economic analyses based upon QResearch.