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

Alison G. Cahill, Anthony O. Odibo, Aaron B. Caughey, David M. Stamilio, Sonia S. Hassan, George A. Macones, Roberto Romero

Research output: Contribution to journalArticle

100 Scopus citations


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 α-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.

Original languageEnglish (US)
Pages (from-to)548.e1-548.e8
JournalAmerican journal of obstetrics and gynecology
Issue number6
StatePublished - Jun 2010



  • cervical length screening
  • preterm birth
  • prevention
  • progesterone

ASJC Scopus subject areas

  • Obstetrics and Gynecology

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