Labour induction near term for women aged 35 or over: an economic evaluation
Objective Induction of labour at 39 weeks for nulliparous women aged 35 years and over may prevent stillbirths and does not increase caesarean births, so it may be popular. But the overall costs and benefits of such a policy have not been compared. Design A cost–utility analysis alongside a randomi...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
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Wiley
2017
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| Online Access: | https://eprints.nottingham.ac.uk/42757/ |
| _version_ | 1848796560332161024 |
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| author | Walker, Kate F. Dritsaki, M. Bugg, George Macpherson, Marion McCormick, Carol Grace, Nicky Wildsmith, Chris Bradshaw, Lucy Smith, Gordon C.S. Thornton, Jim |
| author_facet | Walker, Kate F. Dritsaki, M. Bugg, George Macpherson, Marion McCormick, Carol Grace, Nicky Wildsmith, Chris Bradshaw, Lucy Smith, Gordon C.S. Thornton, Jim |
| author_sort | Walker, Kate F. |
| building | Nottingham Research Data Repository |
| collection | Online Access |
| description | Objective Induction of labour at 39 weeks for nulliparous women aged 35 years and over may prevent stillbirths and does not increase caesarean births, so it may be popular. But the overall costs and benefits of such a policy have not been compared.
Design A cost–utility analysis alongside a randomised controlled trial (the 35/39 trial).
Setting Obstetric departments of 38 UK National Health Service hospitals and one UK primary-care trust.
Population Nulliparous women aged 35 years or over on their expected due date, with a singleton live fetus in a cephalic presentation.
Methods Costs were estimated from the National Health Service and Personal Social Services perspective and quality-adjusted life-years (QALYs) were calculated based on patient responses to the EQ-5D at baseline and 4 weeks.
Main outcome measures Data on antenatal care, mode of delivery, analgesia in labour, method of induction, EQ-5D (baseline and 4 weeks postnatal) and participant-administered postnatal health resource use data were collected.
Results The intervention was associated with a mean cost saving of £263 and a small additional gain in QALYs (though this was not statistically significant), even without considering any possible QALY gains from stillbirth prevention.
Conclusion A policy of induction of labour at 39 weeks for women of advanced maternal age would save money. |
| first_indexed | 2025-11-14T19:49:55Z |
| format | Article |
| id | nottingham-42757 |
| institution | University of Nottingham Malaysia Campus |
| institution_category | Local University |
| last_indexed | 2025-11-14T19:49:55Z |
| publishDate | 2017 |
| publisher | Wiley |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | nottingham-427572020-05-04T18:42:51Z https://eprints.nottingham.ac.uk/42757/ Labour induction near term for women aged 35 or over: an economic evaluation Walker, Kate F. Dritsaki, M. Bugg, George Macpherson, Marion McCormick, Carol Grace, Nicky Wildsmith, Chris Bradshaw, Lucy Smith, Gordon C.S. Thornton, Jim Objective Induction of labour at 39 weeks for nulliparous women aged 35 years and over may prevent stillbirths and does not increase caesarean births, so it may be popular. But the overall costs and benefits of such a policy have not been compared. Design A cost–utility analysis alongside a randomised controlled trial (the 35/39 trial). Setting Obstetric departments of 38 UK National Health Service hospitals and one UK primary-care trust. Population Nulliparous women aged 35 years or over on their expected due date, with a singleton live fetus in a cephalic presentation. Methods Costs were estimated from the National Health Service and Personal Social Services perspective and quality-adjusted life-years (QALYs) were calculated based on patient responses to the EQ-5D at baseline and 4 weeks. Main outcome measures Data on antenatal care, mode of delivery, analgesia in labour, method of induction, EQ-5D (baseline and 4 weeks postnatal) and participant-administered postnatal health resource use data were collected. Results The intervention was associated with a mean cost saving of £263 and a small additional gain in QALYs (though this was not statistically significant), even without considering any possible QALY gains from stillbirth prevention. Conclusion A policy of induction of labour at 39 weeks for women of advanced maternal age would save money. Wiley 2017-04-21 Article PeerReviewed Walker, Kate F., Dritsaki, M., Bugg, George, Macpherson, Marion, McCormick, Carol, Grace, Nicky, Wildsmith, Chris, Bradshaw, Lucy, Smith, Gordon C.S. and Thornton, Jim (2017) Labour induction near term for women aged 35 or over: an economic evaluation. BJOG: An International Journal of Obstetrics & Gynaecology, 124 (6). pp. 929-934. ISSN 1471-0528 Cost-effectiveness; cost–utility; expectant management; induction of labour; nulliparous; advanced maternal age http://onlinelibrary.wiley.com/doi/10.1111/1471-0528.14557/abstract doi:10.1111/1471-0528.14557 doi:10.1111/1471-0528.14557 |
| spellingShingle | Cost-effectiveness; cost–utility; expectant management; induction of labour; nulliparous; advanced maternal age Walker, Kate F. Dritsaki, M. Bugg, George Macpherson, Marion McCormick, Carol Grace, Nicky Wildsmith, Chris Bradshaw, Lucy Smith, Gordon C.S. Thornton, Jim Labour induction near term for women aged 35 or over: an economic evaluation |
| title | Labour induction near term for women aged 35 or over: an economic evaluation |
| title_full | Labour induction near term for women aged 35 or over: an economic evaluation |
| title_fullStr | Labour induction near term for women aged 35 or over: an economic evaluation |
| title_full_unstemmed | Labour induction near term for women aged 35 or over: an economic evaluation |
| title_short | Labour induction near term for women aged 35 or over: an economic evaluation |
| title_sort | labour induction near term for women aged 35 or over: an economic evaluation |
| topic | Cost-effectiveness; cost–utility; expectant management; induction of labour; nulliparous; advanced maternal age |
| url | https://eprints.nottingham.ac.uk/42757/ https://eprints.nottingham.ac.uk/42757/ https://eprints.nottingham.ac.uk/42757/ |