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

Gert Jan Van Baaren, Jolande Y. Vis, William A. Grobman, Patrick M. Bossuyt, Brent C. Opmeer, Ben W. Mol

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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 languageEnglish
Pages (from-to)436.e1-436.e8
Number of pages8
JournalAmerican Journal of Obstetrics and Gynecology
Issue number5
Publication statusPublished - 1 Jan 2013
Externally publishedYes


  • cervical length
  • cost-effectiveness
  • economic evaluation
  • fibronectin
  • preterm labor

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