OBJECTIVE: To investigate the cost-effectiveness of elective induction of labor at 41 weeks in nulliparous women. STUDY DESIGN: A decision analytic model comparing induction of labor at 41 weeks vs expectant management with antenatal testing until 42 weeks in nulliparas was designed. Baseline assumptions were derived from the literature as well as from analysis of the National Birth Cohort dataset and included an intrauterine fetal demise rate of 0.12% in the 41st week and a cesarean rate of 27% in women induced at 41 weeks. One-way and multiway sensitivity analyses were conducted to examine the robustness of the findings. RESULTS: Compared with expectant management, induction of labor is cost-effective with an incremental cost of $10,945 per quality-adjusted life year gained. Induction of labor at 41 weeks also resulted in a lower rate of adverse obstetric outcomes, including neonatal demise, shoulder dystocia, meconium aspiration syndrome, and severe perineal lacerations. CONCLUSION: Elective induction of labor at 41 weeks is cost-effective and improves outcomes.
OBJECTIVE: To investigate the cost-effectiveness of elective induction of labor at 41 weeks in nulliparous women. STUDY DESIGN: A decision analytic model comparing induction of labor at 41 weeks vs expectant management with antenatal testing until 42 weeks in nulliparas was designed. Baseline assumptions were derived from the literature as well as from analysis of the National Birth Cohort dataset and included an intrauterine fetal demise rate of 0.12% in the 41st week and a cesarean rate of 27% in women induced at 41 weeks. One-way and multiway sensitivity analyses were conducted to examine the robustness of the findings. RESULTS: Compared with expectant management, induction of labor is cost-effective with an incremental cost of $10,945 per quality-adjusted life year gained. Induction of labor at 41 weeks also resulted in a lower rate of adverse obstetric outcomes, including neonatal demise, shoulder dystocia, meconium aspiration syndrome, and severe perineal lacerations. CONCLUSION: Elective induction of labor at 41 weeks is cost-effective and improves outcomes.
Authors: Melissa G Rosenstein; Yvonne W Cheng; Jonathan M Snowden; James M Nicholson; Aaron B Caughey Journal: Obstet Gynecol Date: 2012-07 Impact factor: 7.661
Authors: Helen Elden; Henrik Hagberg; Anna Wessberg; Verena Sengpiel; Andreas Herbst; Maria Bullarbo; Christina Bergh; Kristian Bolin; Snezana Malbasic; Sissel Saltvedt; Olof Stephansson; Anna-Karin Wikström; Lars Ladfors; Ulla-Britt Wennerholm Journal: BMC Pregnancy Childbirth Date: 2016-03-07 Impact factor: 3.007
Authors: Rachel G Sinkey; Jasmin Lacevic; Tea Reljic; Iztok Hozo; Kelly S Gibson; Anthony O Odibo; Benjamin Djulbegovic; Charles J Lockwood Journal: PLoS One Date: 2018-04-25 Impact factor: 3.240