An economic evaluation of alternative test-intervention strategies to prevent spontaneous pre-term birth in singleton pregnancies

Acta Obstetricia Et Gynecologica Scandinavica
Angelos TsourapasKhalid S Khan

Abstract

To investigate the potential cost-effectiveness of alternative 'test-and-treat' strategies in the prevention of spontaneous pre-term birth before 34 and 37 weeks' gestation. Model-based economic evaluation. Setting. Clinics, general practices, health centers or any setting delivering antenatal care. Asymptomatic women in early pregnancy and symptomatic women with threatened pre-term labor in later pregnancy. Data from systematic reviews of effectiveness and accuracy were combined into strategies and analyzed using a decision-tree model. Full deterministic and probabilistic sensitivity analyses were carried out. Spontaneous pre-term labor avoided for asymptomatic women and spontaneous pre-term birth avoided for symptomatic women. The systematic reviews identified evidence on the accuracy of 22 types of tests and on the effectiveness of 40 possible interventions. Cost data were based on secondary evidence, supplemented with primary data from local sources. Testing prior to intervention was not shown to be the most cost-effective strategy in the main analyses for 34 and 37 weeks. Prophylactic fish oil in asymptomatic women, without prior testing, was highlighted as potentially cost-effective in preventing threatened pre-term labor...Continue Reading

Citations

Sep 4, 2010·Archives de pédiatrie : organe officiel de la Sociéte française de pédiatrie·F Goffinet
Oct 28, 2011·Reproductive Sciences·Ramkumar MenonChander Arora
Oct 23, 2015·The Cochrane Database of Systematic Reviews·Mary-Ann DaveyShelley Rowlands
May 12, 2011·The Journal of Maternal-fetal & Neonatal Medicine : the Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians·Alev AtisNimet Goker

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