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

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

29 Scopus citations

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 languageEnglish (US)
Pages (from-to)436.e1-436.e8
JournalAmerican journal of obstetrics and gynecology
Volume209
Issue number5
DOIs
StatePublished - Nov 2013

Keywords

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

ASJC Scopus subject areas

  • Obstetrics and Gynecology

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