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. 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. 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. 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.
Original language | English |
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Pages (from-to) | 436.e1-436.e8 |
Number of pages | 8 |
Journal | American Journal of Obstetrics and Gynecology |
Volume | 209 |
Issue number | 5 |
DOIs | |
Publication status | Published - 1 Jan 2013 |
Externally published | Yes |
Keywords
- cervical length
- cost-effectiveness
- economic evaluation
- fibronectin
- preterm labor