ArticleAmerican journal of obstetrics & gynecology MFM2021
Cost-effectiveness of a gestational age metabolic algorithm for preterm and small-for-gestational-age classification.
Article in American journal of obstetrics & gynecology MFM, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed, 14 citations in OpenAlex.
- Current Status of Newborn Bloodspot Screening Worldwide 2024: A Comprehensive Review of Recent Activities (2020-2023).International journal of neonatal screening · 2024Review
- Accuracy of prenatal and postnatal biomarkers for estimating gestational age: a systematic review and meta-analysis.EClinicalMedicine · 2024Article
- Association between gestational weight gain and preterm birth and post-term birth: a longitudinal study from the National Vital Statistics System database.BMC pediatrics · 2023Article
- Validation of gestational age determination from ultrasound or a metabolic gestational age algorithm using exact date of conception in a cohort of newborns conceived using assisted reproduction technologies.AJOG global reports · 2022Article
- Effects of Yoga exercise on anxiety and fetus growth in pregnant women with small for gestational age fetus.American journal of translational research · 2022Article
- Real world external validation of metabolic gestational age assessment in Kenya.PLOS global public health · 2022Article
- Metabolic gestational age assessment in low resource settings: a validation protocol.Gates open research · 2020Article
- A novel way of determining gestational age upon the birth of a child.Journal of global healthReview
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Authors and funding
8 authors at 5 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPreterm birth complications are the leading cause of death among children under 5 years of age, and this imposes a heavy burden on healthcare and social systems, particularly in low- and middle-income countries where reliable estimates of gestational age may be difficult to obtain. Metabolic analyte data can aid in accurately estimating gestational age. However, important costs are associated with this approach, which are related to the collection and analysis of newborn samples, and its cost-effectiveness has yet to be determined.
objectiveThis study aimed to evaluate the cost-effectiveness of an internationally validated gestational age estimation algorithm based on neonatal blood spot metabolite data in combination with clinical and demographic variables (birthweight, sex, and multiple birth status) compared with a basic algorithm that uses only clinical and demographic variables in classifying infants as preterm or term (using a 37-week dichotomous preterm or term classification) and determining gestational age. STUDY
designThe cost per correctly classified preterm infant and per correctly classified small-for-gestational-age infant for the metabolic algorithm vs the basic algorithm were estimated with data from an implementation study in Bangladesh.
resultsOver 1 year, the metabolic algorithm correctly classified an average of 8.7 (95% confidence interval, 1.3-14.7) additional preterm infants and 145.3 (95% confidence interval, 128.0-164.7) additional small-for-gestational-age infants per 1323 infants screened compared with the basic algorithm using only clinical and demographic variables. The incremental annual cost of adopting the metabolic algorithm was $100,031 (95% confidence interval, $86,354-$115,725). If setup costs were included, the cost was $120,496 (95% confidence interval, $106,322-$136,656). Compared with the basic algorithm, the incremental cost per preterm infant correctly classified by the metabolic algorithm is $11,542 ($13,903 with setup), and the incremental cost per small-for-gestational-age infant is $688 ($829 with setup).
conclusionThis research quantifies the cost per detection of preterm or small-for-gestational-age infant in the implementation of a newborn screening program to aid in improved classification of preterm and, in particular, small-for-gestational-age infants in low- and middle-income countries.
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