Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Comparative Study
. 2010 Oct 11:10:60.
doi: 10.1186/1471-2393-10-60.

Cost-effectiveness of recurrence risk guided care versus care as usual in women who suffered from early-onset preeclampsia including HELLP syndrome in their previous pregnancy (the PreCare study)

Denise H J Delahaije  1 , Sander M J van Kuijk, Carmen D Dirksen, Simone J S Sep, Louis L Peeters, Marc E Spaanderman, Hein W Bruinse, Laura D de Wit-Zuurendonk, Joris A M van der Post, Johannes J Duvekot, Jim van Eyck, Mariëlle G van Pampus, Mark A B H M van der Hoeven, Luc J Smits
Affiliations
Comparative Study

Cost-effectiveness of recurrence risk guided care versus care as usual in women who suffered from early-onset preeclampsia including HELLP syndrome in their previous pregnancy (the PreCare study)

Denise H J Delahaije et al. BMC Pregnancy Childbirth. .

Abstract

Background: Preeclampsia and HELLP syndrome may have serious consequences for both mother and fetus. Women who have suffered from preeclampsia or the HELLP syndrome, have an increased risk of developing preeclampsia in a subsequent pregnancy. However, most women will develop no or only minor complications. In this study, we intend to determine cost-effectiveness of recurrence risk guided care versus care as usual in pregnant women with a history of early-onset preeclampsia.

Methods/design: We developed a prediction model to estimate the individual risk of recurrence of early-onset preeclampsia and the HELLP syndrome. In a before-after study, pregnant women with preeclampsia or HELLP syndrome in their previous pregnancy receiving care as usual (before introduction of the prediction model) will be compared with women receiving recurrence risk guided care (after introduction of the prediction model). Eligible and pregnant women will be recruited at six university hospitals and seven large non-university tertiary referral hospitals in the Netherlands. The primary outcome measure is the recurrence of early-onset preeclampsia or HELLP syndrome in women allocated to the regular monitoring group. For the economic evaluation, a modelling approach will be used. Costs and effects of recurrence risk guided care with those of care as usual will be compared by means of a decision model. Two incremental cost-effectiveness ratios will be calculated: 1) cost per Quality Adjusted Life Year (mother unit of analysis) and 2) cost per live born child (child unit of analysis).

Discussion: This is, to our knowledge, the first study that evaluates prospectively the efficacy of a multivariable prediction rule for recurrent hypertensive disease in pregnancy. Results of this study could either be integrated into the current guideline on Hypertensive Disorders in Pregnancy, or be used to develop a new guideline.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Design of the study.
Figure 2
Figure 2
Recurrence risk guided care (phase 2).
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Davison JM, Homuth V, Jeyabalan A, Conrad KP, Karumanchi A, Quaggin S, Dechend R, Luft FC. New aspects in the pathophysiology of preeclampsia. J Am Soc Nephrol. 2004;15:2440–2448. doi: 10.1097/01.ASN.0000135975.90889.60. - DOI - PubMed
    1. Barden A. Pre-eclampsia: contribution of maternal constitutional factors and the consequences for cardiovascular health. Clin Exp Pharmacol Physiol. 2006;33:826–830. doi: 10.1111/j.1440-1681.2006.04448.x. - DOI - PubMed
    1. Meads CA, Cnossen JS, Meher S, Juarez-Garcia A, ter Riet G, Duley L, Roberts TE, Mol BW, van der Post JA, Leeflang MM, Barton PM, Hyde CJ, Gupta JK, Khan KS. Methods of prediction and prevention of pre- eclampsia: systematic reviews of accuracy and effectiveness literature with economic modelling. Health Technol Assess. 2008;12:1–270. - PubMed
    1. Osmond C, Kajantie E, Forsén TJ, Eriksson JG, Barker DJ. Infant growth and stroke in adult life: the Helsinke Birth Cohort Study. Stroke. 2007;38:264–270. doi: 10.1161/01.STR.0000254471.72186.03. - DOI - PubMed
    1. Eriksson JG, Forsén T, Tuomilheto J, Osmond C, Barker DJ. Early growth and coronary heart disease in later life: longitudinal study. BMJ. 2001;322:949–953. doi: 10.1136/bmj.322.7292.949. - DOI - PMC - PubMed

Publication types

MeSH terms

LinkOut - more resources