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 Caughey, David M. Stamilio, Sonia S. Hassan, George A. Macones, Roberto Romero

Research output: Contribution to journalArticle

98 Citations (Scopus)

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 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

Original languageEnglish (US)
JournalAmerican Journal of Obstetrics and Gynecology
Volume202
Issue number6
DOIs
StatePublished - Jun 2010
Externally publishedYes

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Decision Support Techniques
Premature Birth
Progesterone
Economics
Costs and Cost Analysis
Therapeutics
17-alpha-Hydroxyprogesterone
Quality-Adjusted Life Years
Cost-Benefit Analysis
Morbidity

Keywords

  • cervical length screening
  • preterm birth
  • prevention
  • progesterone

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this

Universal cervical length screening and treatment with vaginal progesterone to prevent preterm birth : a decision and economic analysis. / Cahill, Alison G.; Odibo, Anthony O.; Caughey, Aaron; Stamilio, David M.; Hassan, Sonia S.; Macones, George A.; Romero, Roberto.

In: American Journal of Obstetrics and Gynecology, Vol. 202, No. 6, 06.2010.

Research output: Contribution to journalArticle

Cahill, Alison G. ; Odibo, Anthony O. ; Caughey, Aaron ; Stamilio, David M. ; Hassan, Sonia S. ; Macones, George A. ; Romero, Roberto. / Universal cervical length screening and treatment with vaginal progesterone to prevent preterm birth : a decision and economic analysis. In: American Journal of Obstetrics and Gynecology. 2010 ; Vol. 202, No. 6.
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