Cost-effectiveness analysis of cervical length measurement and fibronectin testing in women with threatened preterm labor.

Authors :: van Baaren GJ
Vis JY
Grobman WA
Bossuyt PM
Opmeer BC
Mol BW
Source :: American journal of obstetrics and gynecology [Am J Obstet Gynecol] 2013 Nov; Vol. 209 (5), pp. 436.e1-8. Date of Electronic Publication: 2013 Jun 19.
Publication Year :: 2013
Abstract: Objective: The objective of the study was to evaluate the cost-effectiveness of risk stratification with cervical length (CL) measurement and/or fetal fibronectin (fFN) tests in women with threatened preterm labor between 24 and 34 weeks' gestation.<br />Study Design: We performed a model-based cost-effectiveness analysis to evaluate 7 test-treatment strategies in women with threatened preterm labor from a health care system perspective. Estimates on disease prevalence, costs, and test accuracy were based on medical literature.<br />Results: We found that additional fFN testing in the case of a CL between 10 and 30 mm is cost saving without compromising neonatal health outcomes, compared with a treat-all strategy or single CL testing. Implementing this strategy could lead to an annual cost saving between €2.8 million and €14.4 million in The Netherlands, a country with about 180,000 deliveries annually.<br />Conclusion: In women with threatened preterm labor between 24 and 34 weeks of gestation, the most cost-effective test strategy uses a combination of CL and fFN testing.<br /> (Copyright © 2013 Mosby, Inc. All rights reserved.)

Subjects :: Biomarkers analysis
Cervical Length Measurement statistics & numerical data
Cost-Benefit Analysis
Female
Humans
Infant, Newborn
Models, Economic
Netherlands
Obstetric Labor, Premature economics
Pregnancy
Premature Birth economics
Cervical Length Measurement economics
Fibronectins analysis
Health Care Costs statistics & numerical data
Obstetric Labor, Premature diagnosis
Premature Birth prevention & control
Risk Assessment economics

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