An economic analysis of induction of labour and expectant monitoring in women with gestational hypertension or pre-eclampsia at term (HYPITAT trial)

被引：40

作者：

Vijgen, S. M. C. ^{[1
]}

Koopmans, C. M. ^{[2
]}

Opmeer, B. C.

Groen, H. ^{[2
]}

Bijlenga, D.

Aarnoudse, J. G. ^{[2
]}

Bekedam, D. J. ^{[3
]}

van den Berg, P. P. ^{[2
]}

de Boer, K. ^{[4
]}

Burggraaff, J. M. ^{[5
]}

Bloemenkamp, K. W. M. ^{[6
]}

Drogtrop, A. P. ^{[7
]}

Franx, A. ^{[8
]}

de Groot, C. J. M. ^{[9
]}

Huisjes, A. J. M. ^{[10
]}

Kwee, A. ^{[11
]}

van Loon, A. J. ^{[12
]}

Lub, A. ^{[13
]}

Papatsonis, D. N. M. ^{[14
]}

van der Post, J. A. M.

Roumen, F. J. M. E. ^{[15
]}

Scheepers, H. C. J. ^{[16
]}

Stigter, R. H. ^{[17
]}

Willekes, C. ^{[18
]}

Mol, B. W. J. ^{[19
]}

Van Pampus, M. G. ^{[2
]}

机构：

[1] Acad Med Ctr, Dept Obstet & Gynaecol, NL-1100 DD Amsterdam, Netherlands

[2] Univ Groningen, Univ Med Ctr Groningen, Groningen, Netherlands

[3] Onze Lieve Vrouw Hosp, Amsterdam, Netherlands

[4] Hosp Rijnstate, Arnhem, Netherlands

[5] Scheper Hosp, Emmen, Netherlands

[6] Leiden Univ, Med Ctr, Leiden, Netherlands

[7] Twee Steden Hosp, Tilburg, Netherlands

[8] Sint Elisabeth Hosp, Tilburg, Netherlands

[9] Med Ctr Haaglanden, The Hague, Netherlands

[10] Gelre Hosp, Apeldoorn, Netherlands

[11] Univ Med Ctr, Utrecht, Netherlands

[12] Martini Hosp, Groningen, Netherlands

[13] Spaarne Hosp, Hoofddorp, Netherlands

[14] Amphia Hosp, Breda, Netherlands

[15] Atrium Med Ctr, Heerlen, Netherlands

[16] Univ Med Ctr, Nijmegen, Netherlands

[17] Deventer Hosp, Deventer, Netherlands

[18] Univ Hosp, Maastricht, Netherlands

[19] Maxima Med Ctr, Veldhoven, Netherlands

来源：

BJOG-AN INTERNATIONAL JOURNAL OF OBSTETRICS AND GYNAECOLOGY | 2010年 / 117卷 / 13期

关键词：

Cost-effectiveness; expectant monitoring; gestational hypertension; induction of labour; pre-eclampsia; PREGNANCY;

D O I：

10.1111/j.1471-0528.2010.02710.x

中图分类号：

R71 [妇产科学];

学科分类号：

100211 ;

摘要：

Objective To assess the economic consequences of labour induction compared with expectant monitoring in women with gestational hypertension or pre-eclampsia at term. Design An economic analysis alongside the Hypertension and Preeclampsia Intervention Trial At Term (HYPITAT). Setting Obstetric departments of six university and 32 teaching and district hospitals in the Netherlands. Population Women diagnosed with gestational hypertension or pre-eclampsia between 36(+0) and 41(+0) weeks of gestation, randomly allocated to either induction of labour or expectant monitoring. Methods A trial-based cost-effectiveness analysis was performed from a societal perspective during a 1-year time horizon. Main outcome measures One-year costs were estimated and health outcomes were expressed as the prevalence of poor maternal outcome defined as either maternal complications or progression to severe disease. Results The average costs of induction of labour (n = 377) were (sic)7077 versus (sic)7908 for expectant monitoring (n = 379), with an average difference of -(sic)831 (95% CI -(sic)1561 to -(sic)144). This 11% difference predominantly originated from the antepartum period: per woman costs were (sic)1259 for induction versus (sic)2700 for expectant monitoring. During delivery, more costs were generated following induction ((sic)2190) compared with expectant monitoring ((sic)1210). No substantial differences were found in the postpartum, follow-up and for non-medical costs. Conclusion In women with gestational hypertension or mild pre-eclampsia at term, induction of labour is less costly than expectant monitoring because of differences in resource use in the antepartum period. As the trial already demonstrated that induction of labour results in less progression to severe disease without resulting in a higher caesarean section rate, both clinical and economic consequences are in favour of induction of labour in these women.

引用

页码：1577 / 1585

页数：9

共 12 条

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