Women’s Preferences for Maternal and Neonatal Morbidity and Mortality in Childbirth

Brownsyne Tucker Edmonds, Fatima McKenzie, Stephen M. Downs and Aaron E. Carroll
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Brownsyne Tucker Edmonds: Department of OB/GYN, Indiana University School of Medicine, Indianapolis, IN, USA
Fatima McKenzie: Department of OB/GYN, Indiana University School of Medicine, Indianapolis, IN, USA
Stephen M. Downs: Children’s Health Services Research, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA
Aaron E. Carroll: Pediatric and Adolescent Comparative Effectiveness Research, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA

Medical Decision Making, 2019, vol. 39, issue 7, 755-764

Abstract: Purpose. To measure utility values that describe women’s willingness to tradeoff maternal morbidity for fetal benefit among pregnant and nonpregnant women of reproductive age. Methods. We recruited English-speaking women aged 18 to 45 years in clinical and community-based settings. Eight health states were studied: 4 maternal (healthy, stroke, hysterectomy, death) and 4 neonatal (healthy, severe cerebral palsy [CP], severe mental retardation [MR], death). Utilities were assessed on a subset of 9 pairs of mom/baby delivery outcomes. Participants ranked the 9 pairs of outcomes in order of preference, then standard gamble methods were used to calculate utilities. Numeracy skills were assessed. Results. Utilities were obtained from 477 participants (recruitment rate = 94%). Twenty-one percent were pregnant, 63% were parents, and 54% were African American. Utilities did not differ significantly between pregnant and nonpregnant women or based on numeracy score. The highest (nonhealthy) values were assigned to baby healthy/mom hysterectomy (0.999), baby healthy/mom stroke (0.946), and baby CP/mom healthy (0.940). The lowest values were assigned to baby death/mom hysterectomy (0.203), baby MR/mom death (0.150), and baby death/mom stroke (0.087). Nonwhite participants assigned a significantly higher value to baby MR/mom death ( P = 0.01), baby MR/mom stroke ( P = 0.02), baby MR/mom healthy ( P

Keywords: fetal outcomes; maternal outcomes; obstetrical decision making; utilities (search for similar items in EconPapers)
Date: 2019
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Persistent link: https://EconPapers.repec.org/RePEc:sae:medema:v:39:y:2019:i:7:p:755-764

DOI: 10.1177/0272989X19869910

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