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  • Alkmark, Mårten,1973Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för obstetrik och gynekologi,Institute of Clinical Sciences, Department of Obstetrics and Gynecology,Centre of Perinatal Medicine & Health, Department of Obstetrics and Gynaecology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Region Västra Götaland, Sahlgrenska University Hospital, Department of Obstetrics and Gynecology, Gothenburg, Sweden,Univ Gothenburg, Sahlgrenska Acad, Dept Obstet & Gynaecol, Ctr Perinatal Med & Hlth,Inst Clin Sci, Gothenburg, Sweden.;Sahlgrens Univ Hosp, Reg Vastra Gotaland, Dept Obstet & Gynaecol, Gothenburg, Sweden. (författare)

Induction of labour at 41weeks of gestation versus expectant management and induction of labour at 42weeks of gestation: a cost-effectiveness analysis

  • Artikel/kapitelEngelska2022

Förlag, utgivningsår, omfång ...

  • 2021-10-12
  • Wiley,2022

Nummerbeteckningar

  • LIBRIS-ID:oai:gup.ub.gu.se/314106
  • https://gup.ub.gu.se/publication/314106URI
  • https://doi.org/10.1111/1471-0528.16929DOI
  • https://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-94572URI
  • https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-495276URI
  • http://kipublications.ki.se/Default.aspx?queryparsed=id:147813166URI

Kompletterande språkuppgifter

  • Språk:engelska

Ingår i deldatabas

Klassifikation

  • Ämneskategori:ref swepub-contenttype
  • Ämneskategori:art swepub-publicationtype

Anmärkningar

  • Funding agencies:Swedish County Councils (the ALF agreement: Avtal om lakarutbildning och forskning) ALFGBG-718721 ALFGBG-718591Foundation of the Health and Medical care committee of the Region of Västra Götaland, Sweden VGFOUREG-854081 VGFOUREG-640891Hjalmar Svensson FoundationUppsala-Örebro Regional Research Council RFR-556711 RFR-736891
  • Objective: To assess the cost-effectiveness of induction of labour (IOL) at 41weeks of gestation compared with expectant management until 42weeks of gestation. Design: A cost-effectiveness analysis alongside the Swedish Post-term Induction Study (SWEPIS), a multicentre, randomised controlled superiority trial. Setting: Fourteen Swedish hospitals during 2016–2018. Population: Women with an uncomplicated singleton pregnancy with a fetus in cephalic position were randomised at 41weeks of gestation to IOL or to expectant management and induction at 42weeks of gestation. Methods: Health benefits were measured in life years and quality-adjusted life years (QALYs) for mother and child. Total cost per birth was calculated, including healthcare costs from randomisation to discharge after delivery, for mother and child. Incremental cost-effectiveness ratios (ICERs) were calculated by dividing the difference in mean cost between the trial arms by the difference in life years and QALYs, respectively. Sampling uncertainty was evaluated using non-parametric bootstrapping. Main outcome measures: The cost per gained life year and per gained QALY. Results: The differences in life years and QALYs gained were driven by the difference in perinatal mortality alone. The absolute risk reduction in mortality was 0.004 (from 6/1373 to 0/1373). Based on Swedish life tables, this gives a mean gain in discounted life years and QALYs of 0.14 and 0.12 per birth, respectively. The mean cost per birth was €4108 in the IOL group (n=1373) and €4037 in the expectant management group (n=1373), with a mean difference of €71 (95%CI −€232 to €379). The ICER for IOL compared with expectant management was €545 per life year gained and €623 per QALY gained. Confidence intervals were relatively wide and included the possibility that IOL had both lower costs and better health outcomes. Conclusions: Induction of labour at 41weeks of gestation results in a better health outcome and no significant difference in costs. IOL is cost-effective compared with expectant management until 42weeks of gestation using standard threshold values for acceptable cost per life year/QALY. Tweetable abstract: Induction of labour at 41weeks of gestation is cost-effective compared with expectant management until 42weeks of gestation.

Ämnesord och genrebeteckningar

Biuppslag (personer, institutioner, konferenser, titlar ...)

  • Wennerholm, Ulla-Britt,1948Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för obstetrik och gynekologi,Institute of Clinical Sciences, Department of Obstetrics and Gynecology,Centre of Perinatal Medicine & Health, Department of Obstetrics and Gynaecology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Region Västra Götaland, Sahlgrenska University Hospital, Department of Obstetrics and Gynecology, Gothenburg, Sweden,Univ Gothenburg, Sahlgrenska Acad, Dept Obstet & Gynaecol, Ctr Perinatal Med & Hlth,Inst Clin Sci, Gothenburg, Sweden.;Sahlgrens Univ Hosp, Reg Vastra Gotaland, Dept Obstet & Gynaecol, Gothenburg, Sweden.(Swepub:gu)xwennu (författare)
  • Saltvedt, S.Karolinska Institutet (författare)
  • Bergh, C.Region Västra Götaland, Sahlgrenska University Hospital, Department of Obstetrics and Gynecology, Gothenburg, Sweden,Sahlgrens Univ Hosp, Reg Vastra Gotaland, Dept Obstet & Gynaecol, Gothenburg, Sweden. (författare)
  • Carlsson, Ylva,1975Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för obstetrik och gynekologi,Institute of Clinical Sciences, Department of Obstetrics and Gynecology,Centre of Perinatal Medicine & Health, Department of Obstetrics and Gynaecology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Region Västra Götaland, Sahlgrenska University Hospital, Department of Obstetrics and Gynecology, Gothenburg, Sweden,Univ Gothenburg, Sahlgrenska Acad, Dept Obstet & Gynaecol, Ctr Perinatal Med & Hlth,Inst Clin Sci, Gothenburg, Sweden.;Sahlgrens Univ Hosp, Reg Vastra Gotaland, Dept Obstet & Gynaecol, Gothenburg, Sweden.(Swepub:gu)xcarly (författare)
  • Elden, Helen,1959Gothenburg University,Göteborgs universitet,Institutionen för vårdvetenskap och hälsa,Institute of Health and Care Sciences,Region Västra Götaland, Sahlgrenska University Hospital, Department of Obstetrics and Gynecology, Gothenburg, Sweden; Institute of Health and Caring Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden,Sahlgrens Univ Hosp, Reg Vastra Gotaland, Dept Obstet & Gynaecol, Gothenburg, Sweden.;Univ Gothenburg, Sahlgrenska Acad, Inst Hlth & Caring Sci, Gothenburg, Sweden.(Swepub:gu)xeldhe (författare)
  • Fadl, Helena,1965-Örebro universitet,Institutionen för medicinska vetenskaper,Region Örebro län,Department of Obstetrics and Gynaecology,Örebro Univ, Fac Med & Hlth, Dept Obstet & Gynaecol, Örebro, Sweden.(Swepub:oru)hfl (författare)
  • Jonsson, Maria,1966-Uppsala universitet,Klinisk obstetrik(Swepub:uu)marjo155 (författare)
  • Ladfors, Lars,1951Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för obstetrik och gynekologi,Institute of Clinical Sciences, Department of Obstetrics and Gynecology,Centre of Perinatal Medicine & Health, Department of Obstetrics and Gynaecology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Region Västra Götaland, Sahlgrenska University Hospital, Department of Obstetrics and Gynecology, Gothenburg, Sweden,Univ Gothenburg, Sahlgrenska Acad, Dept Obstet & Gynaecol, Ctr Perinatal Med & Hlth,Inst Clin Sci, Gothenburg, Sweden.;Sahlgrens Univ Hosp, Reg Vastra Gotaland, Dept Obstet & Gynaecol, Gothenburg, Sweden.(Swepub:gu)xladla (författare)
  • Sengpiel, Verena,1977Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för obstetrik och gynekologi,Institute of Clinical Sciences, Department of Obstetrics and Gynecology,Centre of Perinatal Medicine & Health, Department of Obstetrics and Gynaecology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Region Västra Götaland, Sahlgrenska University Hospital, Department of Obstetrics and Gynecology, Gothenburg, Sweden,Univ Gothenburg, Sahlgrenska Acad, Dept Obstet & Gynaecol, Ctr Perinatal Med & Hlth,Inst Clin Sci, Gothenburg, Sweden.;Sahlgrens Univ Hosp, Reg Vastra Gotaland, Dept Obstet & Gynaecol, Gothenburg, Sweden.(Swepub:gu)xsenve (författare)
  • Wesström, Jan,1963-Uppsala universitet,Centrum för klinisk forskning Dalarna,Institutionen för kvinnors och barns hälsa(Swepub:uu)janwe128 (författare)
  • Hagberg, Henrik,1955Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för obstetrik och gynekologi,Institute of Clinical Sciences, Department of Obstetrics and Gynecology,Centre of Perinatal Medicine & Health, Department of Obstetrics and Gynaecology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Region Västra Götaland, Sahlgrenska University Hospital, Department of Obstetrics and Gynecology, Gothenburg, Sweden,Univ Gothenburg, Sahlgrenska Acad, Dept Obstet & Gynaecol, Ctr Perinatal Med & Hlth,Inst Clin Sci, Gothenburg, Sweden.;Sahlgrens Univ Hosp, Reg Vastra Gotaland, Dept Obstet & Gynaecol, Gothenburg, Sweden.(Swepub:gu)xhaghe (författare)
  • Svensson, Mikael,1980Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för samhällsmedicin och folkhälsa,Institute of Medicine, School of Public Health and Community Medicine,School of Public Health & Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden,Univ Gothenburg, Sahlgrenska Acad, Inst Med, Sch Publ Hlth & Community Med, Gothenburg, Sweden.(Swepub:gu)xsmika (författare)
  • Göteborgs universitetInstitutionen för kliniska vetenskaper, Avdelningen för obstetrik och gynekologi (creator_code:org_t)

Sammanhörande titlar

  • Ingår i:BJOG: An International Journal of Obstetrics and Gynaecology: Wiley129:13, s. 2157-21651470-03281471-0528

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