ArticleBJOG : an international journal of obstetrics and gynaecology2019
The cost-effectiveness of universal late-pregnancy screening for macrosomia in nulliparous women: a decision analysis.
Article in BJOG : an international journal of obstetrics and gynaecology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 5 of them syntheses that pooled it.
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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.
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13 citing papers in PubMed, 5 syntheses or guidelines pooled it, 22 citations in OpenAlex.
- How are maternal and fetal outcomes incorporated when measuring benefits of interventions in pregnancy? Findings from a systematic review of cost-utility analyses.Health and quality of life outcomes · 2024Pooled it
- A Systematic Review of Methods and Practice for Integrating Maternal, Fetal, and Child Health Outcomes, and Family Spillover Effects into Cost-Utility Analyses.PharmacoEconomics · 2024Pooled it
- Benefits and harms of antenatal and newborn screening programmes in health economic assessments: the VALENTIA systematic review and qualitative investigation.Health technology assessment (Winchester, England) · 2024Pooled it
- Universal late pregnancy ultrasound screening to predict adverse outcomes in nulliparous women: a systematic review and cost-effectiveness analysis.Health technology assessment (Winchester, England) · 2021Pooled it
- Costing the impact of interventions during pregnancy in the UK: a systematic review of economic evaluations.BMJ open · 2020Pooled it
- Cost-Effectiveness of Routine Third Trimester Ultrasound Screening for Fetal Growth Restriction Compared to Care as Usual in Low-Risk Pregnancies: A Pragmatic Nationwide Stepped-Wedge Cluster-Randomized Trial in The Netherlands (the IRIS Study).International journal of environmental research and public health · 2022Trial
- Machine learning-based prediction of large-for-gestational-age neonates in diabetic and non-diabetic pregnancies.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2026Article
- Adverse perinatal outcomes associated with macrosomia in nulliparous women: A multicenter cohort study.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2026Article
- Assessing the risk factors and establishing multivariable prediction models for singleton macrosomia.Frontiers in medicine · 2025Article
- Bringing precision medicine to the management of pregnancy in women with glucokinase-MODY: a study of diagnostic accuracy and feasibility of non-invasive prenatal testing.Diabetologia · 2023Article
- A Maternal Serum Metabolite Ratio Predicts Large for Gestational Age Infants at Term: A Prospective Cohort Study.The Journal of clinical endocrinology and metabolism · 2022Article
- Article
- The cost-effectiveness of universal late-pregnancy screening for macrosomia in nulliparous women: a decision analysis.BJOG : an international journal of obstetrics and gynaecology · 2019Article
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8 authors at 6 institutions in 1 country.
Funding
Abstract
objectiveTo identify the most cost-effective policy for detection and management of fetal macrosomia in late-stage pregnancy.
designHealth economic simulation model.
settingAll English NHS antenatal services. POPULATION: Nulliparous women in the third trimester treated within the UK NHS.
methodsA health economic simulation model was used to compare long-term maternal-fetal health and cost outcomes for two detection strategies (universal ultrasound scanning at approximately 36 weeks of gestation versus selective ultrasound scanning), combined with three management strategies (planned caesarean section versus induction of labour versus expectant management) of suspected fetal macrosomia. Probabilities, costs and health outcomes were taken from literature.
main outcome measuresExpected costs to the NHS and quality-adjusted life-years (QALYs) gained from each strategy, calculation of net benefit and hence identification of most cost-effective strategy.
resultsCompared with selective ultrasound, universal ultrasound increased QALYs by 0.0038 (95% CI 0.0012-0.0076), but also costs by £123.50 (95% CI 99.6-149.9). Overall, the health gains were too small to justify the cost increase given current UK thresholds cost-effective policy was selective ultrasound coupled with induction of labour where macrosomia was suspected.
conclusionsThe most cost-effective policy for detection and management of fetal macrosomia is selective ultrasound scanning coupled with induction of labour for all suspected cases of macrosomia. Universal ultrasound scanning for macrosomia in late-stage pregnancy is not cost-effective. TWEETABLE ABSTRACT: Universal late-pregnancy ultrasound screening for fetal macrosomia is not warranted.
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