Cost-effectiveness of antenatal corticosteroids and tocolytic agents in the management of preterm birth: A systematic review

Sebastian, Elizabeth; Bykersma, Chloe; Eggleston, Alexander John; Eddy, Katherine E.; Chim, Sher Ting; Zahroh, Rana Islamiah; Scott, Nick; Oladapo, Olufemi T.; Vogel, Joshua P.

doi:10.1016/j.eclinm.2022.101496

Cited by 5 publications

(3 citation statements)

References 72 publications

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“…Economic evidence shows that ACS is highly cost-effective, including in low-resource countries. 35,36 The GDG did not recommend in favour of late preterm ACS use, in light of the continuing uncertainties around the benefits and harms in this subgroup and the lack of substantive trial evidence from low-resource countries. The GDG was also aware that trials exploring late preterm ACS use are continuing, and elected to await these results before revisiting this recommendation.…”

Section: W Ho 2 022 R Ecom M E N Dations On Ac S To I M Prov E Pr Ete...mentioning

confidence: 99%

“…The latter review highlighted that ensuring appropriate ACS use needs accurate gestational age assessment, consistent guidelines and training for providers, as well as sufficient supplies and trained, well‐supported staff. Economic evidence shows that ACS is highly cost‐effective, including in low‐resource countries 35,36 . The GDG did not recommend in favour of late preterm ACS use, in light of the continuing uncertainties around the benefits and harms in this subgroup and the lack of substantive trial evidence from low‐resource countries.…”

Section: Who 2022 Recommendations On Acs To Improve Preterm Birth Out...mentioning

confidence: 99%

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The efficacy of antenatal corticosteroids to improve preterm newborn outcomes in low‐resource countries: Are we there yet?

Sultana,

Vogel,

Oladapo

2023

BJOG

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Section: W Ho 2 022 R Ecom M E N Dations On Ac S To I M Prov E Pr Ete...mentioning

confidence: 99%

Section: Who 2022 Recommendations On Acs To Improve Preterm Birth Out...mentioning

confidence: 99%

The efficacy of antenatal corticosteroids to improve preterm newborn outcomes in low‐resource countries: Are we there yet?

Sultana,

Vogel,

Oladapo

2023

BJOG

Self Cite

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“…Six previous studies analysed the cost-effectiveness of antenatal corticosteroid use in early preterm birth; four from high-income countries (the Netherlands, the UK, and the USA) and one from an upper-middleincome country (Brazil). [4][5][6][7][8]13 A modelling study in the Netherlands in 1992 used published cost and efficacy estimates and found that use of antenatal corticosteroids was cost-effective for neonatal survival. 7 The other four studies found that antenatal corticosteroids for early preterm birth was dominant (ie, cost-saving) compared with no intervention due to the reduced need for neonatal interventions, which is consistent with this current study.…”

Section: Figure 3: Cost-effectiveness Plane Of Antenatal Intramuscula...mentioning

confidence: 99%

Antenatal dexamethasone for improving preterm newborn outcomes in low-resource countries: a cost-effectiveness analysis of the WHO ACTION-I trial

Eddy¹,

Vogel²,

Scott³

et al. 2022

The Lancet Global Health

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Comparison of the efficacy of nifedipine with ritodrine, nitroglycerine and magnesium sulfate for the management of preterm labor: a systematic review and meta-analysis

Zamani,

Alimi,

Arabi

et al. 2024

BMC Pregnancy Childbirth

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Background Some studies have compared the efficacy of nifedipine with that of other tocolytic drugs in the treatment of preterm labor, but the reported results are conflicting. Objective To compare the efficacy of nifedipine with that of ritodrine, nitroglycerine and magnesium sulfate for the management of preterm labor. Methods In this systematic review and meta-analysis, PubMed/MEDLINE, Scopus, Clarivate Analytics Web of Science, and Google Scholar were searched until April 3,2024 using predefined keywords. Randomized controlled trials (RCTs) and clinical trials that compared the efficacy of nifedipine with that of ritodrine, nitroglycerine and magnesium sulfate for the management of preterm labor were included. Two authors independently reviewed the articles, assessed their quality and extracted the data. The quality of the included RCTs based on the Cochrane Risk of Bias Tool 1 for clinical trial studies. The risk difference (RD) with the associated 95% confidence interval (CI) was calculated. A forest plot diagram was used to show the comparative point estimates of nifedipine and other tocolytic drugs on the prevention of preterm labor and their associated 95% confidence intervals based on the duration of pregnancy prolongation. Study heterogeneity was evaluated by the I2 index, and publication bias was evaluated by Egger’s test. Results Forty studies enrolling 4336 women were included. According to our meta-analysis, there was a significant difference in the prolongation of preterm labor within the first 48 h between the nifedipine group and the nitroglycerine group (RD, -0.04; 95% CI, -0.08 to -0.00; I2: 32.3%). Additionally, there were significant differences between nifedipine and ritodrine (RD, 0.11; 95% CI, 0.02 to 0.21; I2, 51.2%) for more than one week RD, 0.10; 95% CI, 0.03 to 0.19; I2, 33.2%) and for 34 weeks and more. The difference between nifedipine and magnesium sulfate was not significant in any of the four time points. Conclusions Considering the superiority of nifedipine over ritodrine and nitroglycerine and its similar efficacy to magnesium sulfate for tocolysis, it seems that the side effects of these options determine the first drug line.

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Cost-effectiveness of antenatal corticosteroids and tocolytic agents in the management of preterm birth: A systematic review

Cited by 5 publications

References 72 publications

The efficacy of antenatal corticosteroids to improve preterm newborn outcomes in low‐resource countries: Are we there yet?

The efficacy of antenatal corticosteroids to improve preterm newborn outcomes in low‐resource countries: Are we there yet?

Antenatal dexamethasone for improving preterm newborn outcomes in low-resource countries: a cost-effectiveness analysis of the WHO ACTION-I trial

Comparison of the efficacy of nifedipine with ritodrine, nitroglycerine and magnesium sulfate for the management of preterm labor: a systematic review and meta-analysis

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