Financial toxicity in pregnancy and postpartum

Area of Science:

• Obstetrics and Gynecology
• Health Economics
• Mental Health Research

Background:

• The financial burden of pregnancy in the US is substantial, linked to adverse mental health and birth outcomes.
• Existing financial toxicity research, including the COmprehensive Score for Financial Toxicity (COST) tool, has focused mainly on cancer patients.
• The impact of financial toxicity on obstetric patients remains understudied.

Purpose of the Study:

• To validate the COST tool for use in obstetric patients.
• To measure financial toxicity and its associations with patient outcomes in this population.
• To identify risk factors and consequences of financial toxicity during pregnancy.

Main Methods:

• Survey and medical record data were collected from obstetric patients at a US medical center.
• The COST tool was validated using common factor analysis.
• Linear regression models identified risk factors and associations between financial toxicity and patient outcomes.

Main Results:

• The COST tool identified two constructs: current and future financial toxicity.
• Racial/ethnic group, insurance, neighborhood deprivation, caregiving, and employment were linked to current financial toxicity.
• Both current and future financial toxicity correlated with poorer patient-provider communication, increased depressive symptoms, and stress.

Conclusions:

• The COST tool effectively measures current and future financial toxicity in obstetric patients.
• Financial toxicity is associated with negative impacts on mental health and patient-provider communication.
• Financial toxicity was not linked to birth outcomes or appointment adherence.