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Am J Obstet Gynecol. 2010 Jun;202(6):548.e1-8. doi: 10.1016/j.ajog.2009.12.005. Epub 2010 Jan 15.

Universal cervical length screening and treatment with vaginal progesterone to prevent preterm birth: a decision and economic analysis.

Author information

1
Department of Obstetrics and Gynecology, Washington University in St. Louis, St. Louis, MO, USA.

Abstract

OBJECTIVE:

The purpose of this study was to estimate which strategy is the most cost-effective for the prevention of preterm birth and associated morbidity.

STUDY DESIGN:

We used decision-analytic and cost-effectiveness analyses to estimate which of 4 strategies was superior based on quality-adjusted life-years, cost in US dollars, and number of preterm births prevented.

RESULTS:

Universal sonographic screening for cervical length and treatment with vaginal progesterone was the most cost-effective strategy and was the dominant choice over the 3 alternatives: cervical length screening for women at increased risk for preterm birth and treatment with vaginal progesterone; risk-based treatment with 17 alpha-hydroxyprogesterone caproate (17-OHP-C) without screening; no screening or treatment. Universal screening represented savings of $1339 ($8325 vs $9664), when compared with treatment with 17-OHP-C, and led to a reduction of 95,920 preterm births annually in the United States.

CONCLUSION:

Universal sonographic screening for short cervical length and treatment with vaginal progesterone appears to be cost-effective and yields the greatest reduction in preterm birth at <34 weeks' gestation.

Comment in

PMID:
20079888
PMCID:
PMC2878953
DOI:
10.1016/j.ajog.2009.12.005
[Indexed for MEDLINE]
Free PMC Article

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