Evidence map›Paper›PMID 32026397›Full record

ArticlePharmacoEconomics - open2020

Cost Effectiveness of Antenatal Lifestyle Interventions for Preventing Gestational Diabetes and Hypertensive Disease in Pregnancy.

Cate Bailey, Helen Skouteris, Cheryce L Harrison, Jacqueline Boyle, Rebeccah Bartlett, Briony Hill, Shakila Thangaratinam, Helena Teede, Zanfina Ademi

Open access · goldAbstract read
In one paragraph

Article in PharmacoEconomics - open, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers.

0numbers the graph read from it
0cells of the map it votes in
22citing papers in PubMed
2.6field-weighted citation impact, top 7% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

22 citing papers in PubMed, 46 citations in OpenAlex.

  1. Trial
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  3. A multicountry, multicenter report to identify nutritional risks in female populations using the FIGO Nutrition Checklist.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2026
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  19. Observational
  20. Examining the use of the FIGO Nutrition Checklist in routine antenatal practice: multistakeholder feedback to implementation.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2020
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 3 institutions in 2 countries.

Cate BaileyMonash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.ORCID http://orcid.org/0000-0001-5030-430X
Helen SkouterisMonash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.ORCID http://orcid.org/0000-0001-9959-5750
Cheryce L HarrisonMonash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.ORCID http://orcid.org/0000-0002-3154-4946
Jacqueline BoyleMonash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.
Rebeccah BartlettMonash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.ORCID http://orcid.org/0000-0001-7047-1295
Briony HillMonash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.ORCID http://orcid.org/0000-0003-4993-3963
Shakila ThangaratinamWomen's Health Research Unit, Barts and the London, School of Medicine and Dentistry, Queen Mary University of London, London, UK.
Helena TeedeMonash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.ORCID http://orcid.org/0000-0001-7609-577X
Zanfina AdemiSchool of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia. zanfina.ademi@monash.edu.ORCID http://orcid.org/0000-0002-0625-3522
Monash University · AUMonash Health · AUQueen Mary University of London · GB

Funding

Medical Research Future Fund Through the TAPPC
6 · The paper itself

Abstract

backgroundLifestyle interventions (diet, physical activity and/or behavioural) to optimise gestational weight gain can prevent adverse maternal outcomes such as gestational diabetes, pre-eclampsia and caesarean section.

objectiveWe aimed to model the cost effectiveness of lifestyle interventions during pregnancy on reducing adverse maternal outcomes.

methodsDecision tree modelling was used to determine the cost effectiveness of lifestyle interventions compared with usual care on preventing cases of gestational diabetes and hypertensive disease in pregnancy. Participants were pregnant women receiving routine antenatal care in secondary and tertiary care hospitals. The main outcome measures were cases of gestational diabetes and/or hypertensive disease in pregnancy prevented, costs, and incremental cost-effectiveness ratios. Analysis was conducted from the perspective of the Australian healthcare system, with a time horizon of early pregnancy to discharge after birth.

resultsWomen in the intervention group were 2.25% less likely to have gestational diabetes and/or hypertensive disease in pregnancy (9.53%) compared with the control group (11.78%). Intervention costs were Australian dollars (AUD) 228 per person. Costs were AUD33 per person higher in the intervention group (AUD8281) than the control group (AUD8248). The incremental cost-effectiveness ratio was AUD1470 per case prevented. Sensitivity analysis showed that base-case results were robust. In the probabilistic sensitivity analysis, 44.8% of data points fell within the north-east quadrant, and 52.2% in the south-east quadrant (cost saving), with a 95% confidence interval ranging from AUD - 50,018 to 32,779 per case prevented.

conclusionsWhile there is no formally accepted cost-effectiveness threshold for willingness-to-pay to prevent an adverse maternal event, the cost per person receiving a lifestyle intervention compared with controls was close to neutral, and therefore likely to be cost effective. Exploration of the cost effectiveness of different lifestyle delivery modes across various models of antenatal care is now required. Future cost-effectiveness studies should investigate longer time horizons, quality-adjusted life-years and productivity loss.

trial registrationNot applicable.

Identifiers

PMID32026397
PMCPMC7426355
OpenAlexW3004932941

What Socratic holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.