Cost Effectiveness of Routine Screening of Vaginal Trichomoniasis in Pregnant People [ID 1190]

INTRODUCTION: Trichomonas vaginalis is a significantly common sexually transmitted infection (STI) in women with an estimated incidence exceeding chlamydia, gonorrhea, and syphilis collectively. Trichomoniasis infections are often asymptomatic. Antepartum infections are associated with increased risk of adverse birth outcomes including preterm birth, yet current guidelines do not recommend routine screening in pregnant people. In this study, we report a cost-effectiveness analysis of routine screening of asymptomatic pregnant people and the effect on neonatal health outcomes. METHODS: A decision-analytical model was used to compare costs and outcomes of asymptomatic pregnant people after routine screening versus current guidelines. A theoretical cohort that included 2,873,062 persons was calculated using the total number of live births in the United States by the prevalence of asymptomatic pregnant people. Outcomes included the cost and quality adjusted life years (QALYs) associated with preterm birth, neonatal death, and neurodevelopment delay. A willingness-to-pay operation for incremental cost-effectiveness ratio (ICER) of $100,000/QALY was utilized. Model data originated from literature review. RESULTS: Routine screening and treatment of trichomonas in asymptomatic pregnant people was associated with 7,300 fewer preterm births, 284 fewer neonatal deaths, and 63 fewer neonates with neurodevelopmental delay, and QALYs increase of 180,593. Although there’s an increased cost of $18,528,348, routine screening was cost-effective with an ICER of $103/QALY. CONCLUSIONS/IMPLICATIONS: This cohort analysis suggests a reduction in adverse birth outcomes associated with routine screening of trichomonas in pregnancy and improved quality of life metrics. Routine screening deserves exploration in prospective trials to ascertain the potential gain that might be achieved.