Using ultrasound to screen all pregnant women for signs of a shortening cervix improves pregnancy outcomes and is a cost-effective way to reduce preterm birth, Yale School of Medicine researchers report in a new study.
The results of the study will be presented February 5 at the Annual Scientific Meeting of the Society for Maternal Fetal Medicine (SMFM) in Chicago.
Shortened cervical length increases the likelihood of a preterm birth. All high-risk patients -- those who have had a prior preterm birth -- are routinely screened at 20 to 24 weeks gestation to test for cervical length. However, screening is not often given to low-risk pregnant women, and researchers did not know whether it was cost-effective to screen women at low risk.
Erika Werner, M.D., clinical instructor in the Department of Obstetrics, Gynecology & Reproductive Sciences at Yale, found that screening low-risk women is not only cost effective, it is cost-saving.
Werner and her team developed a computer model to mimic the outcomes and costs that occur when women are screened routinely, compared to when no screening occurs. They found that universal screening was cost-effective when compared to routine care. In fact, for every 100,000 women, routine care costs $6,523,365 more than the screening strategy. It also improved quality of life and resulted in fewer neonatal deaths and infants with long-term neurologic disorders.
"Since only 10 percent of preterm birth occurs in women with a history of preterm birth, cervical length screening may be the best way to decrease the number of babies born prematurely," said Werner.
Other Yale authors on the study included Christina S. Han, M.D., Christian M. Pettker, M.D., Catalin S. Buhimschi, M.D., Joshua A. Copel, M.D., Edmund F. Funai, M.D., and Stephen F. Thung, M.D.
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