ArticleO&G open2026
Use and Out-of-Pocket Costs of Antenatal Fetal Surveillance for Patients With Chronic Conditions.
Article in O&G open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
1 citing paper in PubMed.
- Delivery Timing, Out-Of-Pocket Maternity Costs, and Postpartum Care Utilization: An Instrumental Variable Analysis Among Commercially Insured Women.Health services research · 2026Article
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo measure variation in use and out-of-pocket costs for antenatal fetal surveillance (AFS) among commercially insured patients with chronic hypertension or pregestational diabetes.
methodsThis was a cross-sectional analysis of pregnancies of at least 20 weeks of gestation between 2017 and 2022. We used administrative enrollment and health insurance claims data from the Health Care Cost Institute, which includes commercially insured pregnancies nationwide. Our sample included patients with chronic hypertension or pregestational diabetes. Our outcomes were the number of days with AFS testing during pregnancy, the out-of-pocket costs for those tests, and those costs as a proportion of all out-of-pocket costs during pregnancy. We used linear regression models to compare variation in these outcomes by health plan type, patient factors (age, clinical characteristics), and geographic factors (rurality, maternity care access, and area-level income and race distributions).
resultsOur sample included more than 150,000 pregnancies with chronic hypertension or pregestational diabetes. Patients with chronic hypertension received a median of five AFS tests, and those with pregestational diabetes received a median of six. There was significant variation in the number of AFS tests received, with 15.9% of patients with chronic hypertension and 12.3% of those with pregestational diabetes receiving no AFS tests during pregnancy. Receiving no AFS was most common for patients in areas that were rural or low income or had a higher concentration of Black individuals. One-quarter of patients with chronic conditions faced out-of-pocket costs for AFS of $264 or more or $301 or more for one-quarter of patients with pregestational diabetes. Patients in point-of-service or preferred provider organization plans, in rural areas, and in areas with a higher concentration of White people had higher costs.
conclusionAntenatal fetal surveillance is the primary tool for stillbirth prevention, yet we found wide variation in AFS use and costs in this commercially insured population of high-risk pregnancies, including many patients who receive no AFS.
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Registered trials
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