An economic analysis of immediate delivery and expectant monitoring in women with hypertensive disorders of pregnancy, between 34 and 37 weeks of gestation (HYPITAT-II)
| العنوان: | An economic analysis of immediate delivery and expectant monitoring in women with hypertensive disorders of pregnancy, between 34 and 37 weeks of gestation (HYPITAT-II) |
|---|---|
| المؤلفون: | J. Sikkema, Josje Langenveld, K.W. Bloemenkamp, P.P. van den Berg, Hypitat-Ii Study Grp, Corla B. Vredevoogd, M.G. van Pampus, Hubertina C.J. Scheepers, W. Ganzevoort, Kim Broekhuijsen, M.A. Oudijk, Henk Groen, G. J. van Baaren, Josien Brons, M. Porath, B. W. J. Mol, Mallory Woiski, M.E. van Huizen, D. N. M. Papatsonis, Aren J. van Loon, A.H. van Kaam, R.J. Rijnders, Jan Sporken, M. Kaplan, Denise A. M. Perquin, Maureen T.M. Franssen, H.A. Bremer |
| المساهمون: | Methods in Medicines evaluation & Outcomes research (M2O), Reproductive Origins of Adult Health and Disease (ROAHD), Value, Affordability and Sustainability (VALUE), Obstetrie & Gynaecologie, MUMC+: MA Medische Staf Obstetrie Gynaecologie (9), RS: GROW - R4 - Reproductive and Perinatal Medicine |
| المصدر: | BJOG : An International Journal of Obstetrics and Gynaecology, 124(3), 453-461. Wiley BJOG : an International Journal of Obstetrics and Gynaecology, 124, 453-461 Bjog-an International Journal of Obstetrics and Gynaecology, 124(3), 453-461. Wiley BJOG-An International Journal of Obstetrics and Gynaecology, 124(3), 453. Wiley-Blackwell BJOG : an International Journal of Obstetrics and Gynaecology, 124, 3, pp. 453-461 |
| سنة النشر: | 2017 |
| مصطلحات موضوعية: | Cost effectiveness, Cost-Benefit Analysis, law.invention, COST-EFFECTIVENESS, 0302 clinical medicine, Randomized controlled trial, expectant monitoring, Pregnancy, law, Obstetrics and Gynaecology, Economic analysis, 030212 general & internal medicine, hypertensive disorders, Netherlands, education.field_of_study, 030219 obstetrics & reproductive medicine, Respiratory distress, Obstetrics, INDUCTION, Pregnancy Outcome, Obstetrics and Gynecology, Gestational age, Health Care Costs, PREECLAMPSIA, immediate delivery, Gestation, Female, TRIAL, medicine.medical_specialty, Population, Gestational Age, TERM, 03 medical and health sciences, medicine, Journal Article, Humans, Labor, Induced, Watchful Waiting, education, LABOR, Gynecology, Respiratory Distress Syndrome, Newborn, Eclampsia, business.industry, Other Research Radboud Institute for Health Sciences [Radboudumc 0], Infant, Newborn, Hypertension, Pregnancy-Induced, medicine.disease, Economic evaluation, ECLAMPSIA, business, preterm |
| الوصف: | Item does not contain fulltext OBJECTIVE: To assess the economic consequences of immediate delivery compared with expectant monitoring in women with preterm non-severe hypertensive disorders of pregnancy. DESIGN: A cost-effectiveness analysis alongside a randomised controlled trial (HYPITAT-II). SETTING: Obstetric departments of seven academic hospitals and 44 non-academic hospitals in the Netherlands. POPULATION: Women diagnosed with non-severe hypertensive disorders of pregnancy between 340/7 and 370/7 weeks of gestation, randomly allocated to either immediate delivery or expectant monitoring. METHODS: A trial-based cost-effectiveness analysis was performed from a healthcare perspective until final maternal and neonatal discharge. MAIN OUTCOME MEASURES: Health outcomes were expressed as the prevalence of respiratory distress syndrome, defined as the need for supplemental oxygen for >24 hours combined with radiographic findings typical for respiratory distress syndrome. Costs were estimated from a healthcare perspective until maternal and neonatal discharge. RESULTS: The average costs of immediate delivery (n = 352) were euro10 245 versus euro9563 for expectant monitoring (n = 351), with an average difference of euro682 (95% confidence interval, 95% CI -euro618 to euro2126). This 7% difference predominantly originated from the neonatal admissions, which were euro5672 in the immediate delivery arm and euro3929 in the expectant monitoring arm. CONCLUSION: In women with mild hypertensive disorders between 340/7 and 370/7 weeks of gestation, immediate delivery is more costly than expectant monitoring as a result of differences in neonatal admissions. These findings support expectant monitoring, as the clinical outcomes of the trial demonstrated that expectant monitoring reduced respiratory distress syndrome for a slightly increased risk of maternal complications. TWEETABLE ABSTRACT: Expectant management in preterm hypertensive disorders is less costly compared with immediate delivery. |
| وصف الملف: | image/pdf |
| اللغة: | English |
| تدمد: | 1470-0328 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::7513c77c54742b424f47cda51b025b97 https://doi.org/10.1111/1471-0528.13957 |
| حقوق: | RESTRICTED |
| رقم الأكسشن: | edsair.doi.dedup.....7513c77c54742b424f47cda51b025b97 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 14700328 |
|---|