Cost‐effectiveness of a randomized controlled trial comparing low‐dose aspirin to placebo for the prevention of recurrent preterm birth

To assess the cost-effectiveness of low-dose aspirin compared to placebo for the prevention of recurrent preterm birth from a healthcare perspective. This was a cost-effectiveness analysis alongside a multicenter, randomized, double-blinded, placebo-controlled trial. We included women with a singleton pregnancy and a previous spontaneous preterm birth <37 weeks of gestation of a singleton. Women were randomized between aspirin 80 mg daily and placebo, initiated between 8 and 16 weeks of gestation. We estimated the difference in preterm births (<37 weeks of gestation), and maternal and neonatal healthcare costs using seemingly unrelated linear regression analyses. Bootstrapping was performed to estimate statistical uncertainty. A total of 387 women were included: 194 in the aspirin group and 193 in the placebo group. We observed a small, statistically non-significant difference in preterm birth (21.2% vs. 25.4%; risk difference -4.3%; 95% CI: -12.7% to 4.1%) and healthcare costs (mean -€99; 95% CI: -€2385 to €2325) in the aspirin group compared to placebo. The cost-effectiveness acceptability curve showed that the probability of aspirin being cost-effective was 54% for a willingness to pay threshold of €0 for one prevented preterm birth and 78% for €50 000 for one prevented preterm birth. Our findings suggest that aspirin is the dominant strategy over placebo for the prevention of preterm birth. However, there was substantial uncertainty around the results and definite conclusions regarding the cost-effectiveness of aspirin cannot be drawn.

Authors

Institutions

Publication Details

Journal
International Journal of Gynecology & Obstetrics
Published
2024-11-28
DOI
https://doi.org/10.1002/ijgo.16024
Citations
1
Primary Topic
Preterm Birth and Chorioamnionitis
Type
article
Field-Weighted Citation Impact
0.39

Funders

Controls
|||
ALL TIME
JAN
FEB
MAR
APR
MAY
JUN
JUL
AUG
SEP
OCT
article

Cost‐effectiveness of a randomized controlled trial comparing low‐dose aspirin to placebo for the prevention of recurrent preterm birth

Flip van der Made, Anadeijda J. E. M. C. Landman, Josje Langenveld, Judith Ekkina Bosmans et al.
1 citations
International Journal of Gynecology & Obstetrics
Preterm Birth and Chorioamnionitis
0.39
article

Cost‐effectiveness of a randomized controlled trial comparing low‐dose aspirin to placebo for the prevention of recurrent preterm birth

Flip van der Made, Anadeijda J. E. M. C. Landman, Josje Langenveld, Judith Ekkina Bosmans, Ineke Krabbendam, Tobias A. J. Nijman, Rafli van de Laar, Marjon A. de Boer, Hana M. Broulíková, Roel de Heus, Christianne J.M. de Groot, Liv M. Freeman, Laura Visser, Martijn A. Oudijk, Ben W. Mol, Hubertina Scheepers, Elisabeth M. A. Boormans, Huib A. A. M. van Vliet, Judith Blaauw, Marieke F. G. Verberg, Karlijn C. Vollebregt, Robbert J. P. Rijnders, Marieke A. C. Hemels, Henk A. Bremer, Esther Tuinman
article en
1 citations

Abstract

To assess the cost-effectiveness of low-dose aspirin compared to placebo for the prevention of recurrent preterm birth from a healthcare perspective. This was a cost-effectiveness analysis alongside a multicenter, randomized, double-blinded, placebo-controlled trial. We included women with a singleton pregnancy and a previous spontaneous preterm birth <37 weeks of gestation of a singleton. Women were randomized between aspirin 80 mg daily and placebo, initiated between 8 and 16 weeks of gestation. We estimated the difference in preterm births (<37 weeks of gestation), and maternal and neonatal healthcare costs using seemingly unrelated linear regression analyses. Bootstrapping was performed to estimate statistical uncertainty. A total of 387 women were included: 194 in the aspirin group and 193 in the placebo group. We observed a small, statistically non-significant difference in preterm birth (21.2% vs. 25.4%; risk difference -4.3%; 95% CI: -12.7% to 4.1%) and healthcare costs (mean -€99; 95% CI: -€2385 to €2325) in the aspirin group compared to placebo. The cost-effectiveness acceptability curve showed that the probability of aspirin being cost-effective was 54% for a willingness to pay threshold of €0 for one prevented preterm birth and 78% for €50 000 for one prevented preterm birth. Our findings suggest that aspirin is the dominant strategy over placebo for the prevention of preterm birth. However, there was substantial uncertainty around the results and definite conclusions regarding the cost-effectiveness of aspirin cannot be drawn.

International Journal of Gynecology & ObstetricsVol. 169(1)
Radboud University Nijmegen (NL), University of Aberdeen (GB), Catharina Ziekenhuis (NL), Medisch Spectrum Twente (NL), University Medical Center Utrecht (NL), Maastricht University (NL), Sint Franciscus Gasthuis (NL), Reinier de Graaf Hospital (NL), Spaarne Ziekenhuis (NL), St. Antonius Ziekenhuis (NL), Ikazia Ziekenhuis (NL), Dialyse Centrum Groningen (NL), Treant Zorggroep (NL), VieCuri Medisch Centrum (NL), Ziekenhuis Bethesda (NL), Monash Health (AU), Ziekenhuis Gelderse Vallei (NL), Zuyderland Medisch Centrum (NL), Isala (NL), Amsterdam University Medical Centers (NL), Meander Medisch Centrum (NL), Jeroen Bosch Ziekenhuis (NL), Spaarne Gasthuis (NL), Monash University (AU), Vrije Universiteit Amsterdam (NL)
ZonMw, Medical Research Council, National Health and Medical Research Council
Good health and well-being
Openalex Percentile: Top 32%
Preterm Birth and Chorioamnionitis
0.39
DOIOpen Access PDFOpenAlex
AI Navigator

Ask Laika to Summarize, Analyze, and Connect papers live on the map.

Summarize Papers & Methodologies

Extract key findings, datasets, and comparative methods across publications.

Benchmark Rankings & Visual Analytics

Rank top research institutions, authors, funders, topics, and journals by Field-Weighted Citation Impact (FWCI) and paper volume with instant charts.

Connect Distant Disciplines

Bridge topological clusters on the map to find hidden collaborative intersections.