alexa Screening and treating for primary cytomegalovirus infection in pregnancy: where do we stand? A decision-analytic and economic analysis.
Reproductive Medicine

Reproductive Medicine

Gynecology & Obstetrics

Author(s): Cahill AG, Odibo AO, Stamilio DM, Macones GA

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OBJECTIVE: To estimate which 1 of 3 screening strategies for primary maternal cytomegalovirus infection, with intention to treat with hyperimmune globulin, is most cost-effective. STUDY DESIGN: A decision-analytic and cost-effectiveness model was constructed for pregnant women, comparing 3 strategies screening for primary maternal cytomegalovirus infection with intention to treat with cytomegalovirus-intravenous immune globulin: (1) serum screen all pregnant women, (2) serum screen women with risk factors for primary cytomegalovirus, (3) serum screen women with suspicious sonographic findings. Probability, use (or value), and cost estimates were derived from published literature. RESULTS: Universal screening for primary maternal cytomegalovirus was the preferred and most cost-effective strategy. However, if treatment with cytomegalovirus-intravenous immune globulin achieved less than a 47% reduction (relative risk, 0.53) in clinical disease, universal screening would no longer be cost-effective. CONCLUSION: Universal screening for primary maternal cytomegalovirus infection is cost-effective based on available evidence, highlighting the urgent need for additional study evaluating the efficacy of cytomegalovirus-intravenous immune globulin to prevent congenital cytomegalovirus.

This article was published in Am J Obstet Gynecol. and referenced in Gynecology & Obstetrics

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