Evidence map›Paper›PMID 37415785›Full record

ArticleAJOG global reports2023

Cost-effectiveness analysis of spontaneous vaginal delivery vs elective cesarean delivery for maternal outcomes in Colombia.

Andrés Sarmiento, Nathalia Ayala, Kristian K Rojas, Mónica Pinilla-Roncancio, Nicolás Rodriguez, Darío Londoño, Jennifer S Gil, Andrea Zapata-Arango, Natalia Martinez, José D Ruiz-Rios

Open access · goldAbstract read
In one paragraph

Article in AJOG global reports, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
0.9field-weighted citation impact, top 26% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it, 3 citations in OpenAlex.

  1. Pooled it
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 2 institutions in 1 country.

Andrés SarmientoDepartment of Obstetrics and Gynecology, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá, Colombia (Drs Sarmiento, Ayala, and Rodriguez).
Nathalia AyalaDepartment of Obstetrics and Gynecology, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá, Colombia (Drs Sarmiento, Ayala, and Rodriguez).
Kristian K RojasDivision of Public Health, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá, Colombia (Mr. Rojas and Dr Londoño).
Mónica Pinilla-RoncancioSchool of Medicine, Universidad de los Andes, Bogotá, Colombia (Drs Sarmiento and Ayala, Ms Pinilla-Roncancio, Drs Londoño, Gil, Zapata-Arango, Martinez, and Ruiz-Rios).
Nicolás RodriguezDepartment of Obstetrics and Gynecology, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá, Colombia (Drs Sarmiento, Ayala, and Rodriguez).
Darío LondoñoSchool of Medicine, Universidad de los Andes, Bogotá, Colombia (Drs Sarmiento and Ayala, Ms Pinilla-Roncancio, Drs Londoño, Gil, Zapata-Arango, Martinez, and Ruiz-Rios).
Jennifer S GilSchool of Medicine, Universidad de los Andes, Bogotá, Colombia (Drs Sarmiento and Ayala, Ms Pinilla-Roncancio, Drs Londoño, Gil, Zapata-Arango, Martinez, and Ruiz-Rios).
Andrea Zapata-ArangoSchool of Medicine, Universidad de los Andes, Bogotá, Colombia (Drs Sarmiento and Ayala, Ms Pinilla-Roncancio, Drs Londoño, Gil, Zapata-Arango, Martinez, and Ruiz-Rios).
Natalia MartinezSchool of Medicine, Universidad de los Andes, Bogotá, Colombia (Drs Sarmiento and Ayala, Ms Pinilla-Roncancio, Drs Londoño, Gil, Zapata-Arango, Martinez, and Ruiz-Rios).
José D Ruiz-RiosSchool of Medicine, Universidad de los Andes, Bogotá, Colombia (Drs Sarmiento and Ayala, Ms Pinilla-Roncancio, Drs Londoño, Gil, Zapata-Arango, Martinez, and Ruiz-Rios).
Universidad de Los Andes · COFundación Santa Fe de Bogotá · CO

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIn worldwide literature, it has been found that cesarean deliveries represent higher costs and are associated with maternal morbidity and other complications.

objectiveThis study aimed to estimate the cost-effectiveness of elective cesarean delivery compared with spontaneous vaginal delivery in short-term maternal outcomes for low-risk obstetrical population in Colombia. STUDY

designA cost-effectiveness study using a healthcare-system perspective was performed in 2019 in Colombia. The reference population were women with full-term and low-risk pregnancy, either by spontaneous vaginal delivery or elective cesarean delivery under medical or nonmedical indications. An analytical decision model (decision tree) was designed for maternal outcomes. The time horizon was 42 days postpartum, and the health effects were measured by Quality Adjusted Life Years. A review of the literature and a validation process by a national expert committee were conducted to determine the maternal outcomes and estimate their probabilities. Costs were estimated with a top-down analysis, an incremental cost-effectiveness ratio was calculated, and finally, a sensitivity analysis was performed.

resultsWithin a 42-day time horizon, it was found that spontaneous vaginal delivery is the less-expensive and more-effective mode of delivery, it showed a reduction in costs (324 USD) and a gain in Quality Adjusted Life Years (0.03) compared with elective cesarean delivery. Our analysis suggests that spontaneous vaginal delivery is the dominant alternative compared with elective cesarean delivery.

conclusionSpontaneous vaginal delivery showed to be the cost-effective mode of delivery for low-risk obstetrical population in Columbia. These results are useful not only for obstetricians but for decision makers, who should encourage nationwide health policies in favor of spontaneous vaginal delivery.

Indexed as

cesarean deliverycost-effectiveness analysisvaginal delivery

Identifiers

PMID37415785
PMCPMC10320247
OpenAlexW4323926712

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.