التفاصيل البيبلوغرافية
| العنوان: |
Leaning towards Cytomegalovirus serological screening in pregnancy to prevent congenital infection: a cost‐effectiveness perspective. |
| المؤلفون: |
Seror, V, Leruez‐Ville, M, Ӧzek, A, Ville, Y |
| المصدر: |
BJOG: An International Journal of Obstetrics & Gynaecology; Jan2022, Vol. 129 Issue 2, p301-312, 12p |
| مصطلحات موضوعية: |
CONGENITAL disorders, MEDICAL screening, PRENATAL diagnosis, CYTOMEGALOVIRUS diseases, COST effectiveness, ABORTION |
| مستخلص: |
Objective: To assess the cost‐effectiveness of prenatal detection of congenital cytomegalovirus (cCMV) following maternal primary infection in the first trimester within standard pregnancy follow‐up or involving population‐based screening (serological testing at 7 and 12 weeks of gestation), with or without secondary prevention (valaciclovir) in maternal CMV primary infection. Design: Cost‐effectiveness study from the perspective of the French national health insurance system. Setting: Cost‐effectiveness based on previously published probability estimates and associated plausible ranges hypothetical population of 1,000,000 pregnant women. Population: Hypothetical population of 1,000,000 pregnant women. Methods: Cost‐effectiveness of detecting fetal cCMV in terms of the total direct medical costs involved and associated expected outcomes. Main outcome measures: Detection rates and clinical outcomes at birth. Results: Moving to a population‐based approach for targeting fetal CMV infections would generate high monetary and organizational costs while increasing detection rates from 15% to 94%. This resource allocation would help implementing horizontal equity according to which individuals with similar medical needs should be treated equally. Secondary prevention with valaciclovir had a significant effect on maternal‐fetal CMV transmission and clinical outcomes in newborns, with a 58% decrease of severely infected newborns for a 3.5% additional total costs. Accounting for women decision‐making (amniocentesis uptake and termination of pregnancy in severe cases) did not impact the cost‐effectiveness results. Conclusions: These findings could fuel thinking on the opportunity of developing clinical guidelines to rule identification of cCMV infection and administration of in‐utero treatment. These findings could fuel the development of clinical guidelines on the identification of congenital CMV infection and the administration of treatment in utero. CMV serological screening followed by valaciclovir prevention may prevent 58% to 71% of severe cCMV cases for 38 € per pregnancy. CMV serological screening followed by valaciclovir prevention may prevent 58% to 71% of severe cCMV cases for 38 € per pregnancy. [ABSTRACT FROM AUTHOR] |
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| قاعدة البيانات: |
Complementary Index |
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