Cost-Effectiveness of Routine Third Trimester Ultrasound Screening for Fetal Growth Restriction Compared to Care as Usual in Low-Risk Pregnancies

A Pragmatic Nationwide Stepped-Wedge Cluster-Randomized Trial in The Netherlands (the Iris Study)

Bibliographic Data

ID15479709
AuthorsJens Henrichs (0000-0003-2238-4060, Vrije Universiteit Amsterdam, corresponding author), Ank de Jonge (0000-0002-5384-3744, Vrije Universiteit Amsterdam), Myrte Westerneng (0000-0002-4196-3482, Vrije Universiteit Amsterdam), Viki Verfaille (0000-0002-7686-9509, Vrije Universiteit Amsterdam), Arie Franx (0000-0001-8801-5546, Erasmus MC), Henriëtte E van der Horst (0000-0003-4060-4354, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Department of General Practice, Amsterdam Public Health, Van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands), Judith E Bosmans (0000-0002-1443-1026, Vrije Universiteit Amsterdam)
Year2022
Volume19
Issue6
Pages3312-3312
Publication date2022-03-11
Open AccessYes
TypeARTICLE
VenueInternational Journal of Environmental Research and Public Health (JOURNAL)
Journal identifiersISSN: 1661-7827 • E-ISSN: 1660-4601
PublisherMultidisciplinary Digital Publishing Institute (PUBLISHER • CH)
DOI10.3390/ijerph19063312
PMID35329004
OpenAlexW4221102156
LanguageEN
References cited26

Routine third trimester ultrasonography is increasingly used to screen for fetal growth restriction. However, evidence regarding its cost-effectiveness is lacking. We aimed to evaluate the cost-effectiveness of routine third trimester ultrasonography to reduce adverse perinatal outcomes compared to usual care (selective ultrasonography). An economic evaluation alongside a stepped-wedge cluster-randomized trial was conducted. Via 60 midwifery practices 12,974 Dutch women aged ≥16 years with low-risk pregnancies were enrolled at 22.8 (SD = 2.4) weeks' gestation. All practices provided usual care. At 3, 7, and 10 months a third of the practices were randomized to the intervention strategy providing routine ultrasonography at 28-30 and 34-36 weeks' gestation and usual care. The primary clinical outcome was a dichotomous composite measure of 12 severe adverse perinatal outcomes (SAPO) up to one week postpartum. Information on perinatal care and societal costs was derived from Netherlands Perinatal Registry, hospital records and a survey. Cost-effectiveness analyses revealed no significant differences in SAPO and healthcare and societal costs between the intervention strategy ( n = 7026) and usual care ( n = 5948). Cost-effectiveness acceptability curves showed that the probability of cost-effectiveness was never higher than 0.6 for all possible ceiling ratios. Adding routine third trimester ultrasonography to usual care is not cost-effective in reducing SAPO

Biology · Cluster (spacecraft · Cluster randomised controlled trial · Fetal growth · Fetus · Obstetrics · Pregnancy · Randomized controlled trial · Third trimester · Assisted Reproductive Technology and Twin Pregnancy · Birth, Development, and Health · Computer Science · Medicine · Pregnancy and preeclampsia studies · Surgery

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