Cost‐effectiveness of prenatal screening methods for congenital heart defects in pregnancies conceived by <i>in‐vitro</i> fertilization

Chung, Esther H.; Lim, Stephanie; Havrilesky, Laura J.; Steiner, Anne Z.; Dotters‐Katz, Sarah K.

doi:10.1002/uog.22048

Cited by 10 publications

(24 citation statements)

References 51 publications

(92 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Seven were included in the evidence synthesis and appraisal. [13][14][15][16][17][18][19] The study selection process is presented through the flowchart proposed by the PRISMA 11 statement in Figure 1.…”

Section: Search Results and Narrative Synthesis Of Evidencementioning

confidence: 99%

“…Four articles were carried out from the perspective of the national health authority of their respective countries, 13,14,18,19 2 from the social perspective 15,17 and 1 from the point of view of the service provider. 16 Four did not report the time horizon in which costs and health consequences were evaluated, 13,16,17,19 2 adopted short-term horizons, taking as reference the time necessary for the diagnosis 18 , and 1 with a time horizon 1 year after childbirth.…”

Section: Search Results and Narrative Synthesis Of Evidencementioning

confidence: 99%

“…16 Four did not report the time horizon in which costs and health consequences were evaluated, 13,16,17,19 2 adopted short-term horizons, taking as reference the time necessary for the diagnosis 18 , and 1 with a time horizon 1 year after childbirth. 15 Only 1 study performed the analysis with a vital horizon. 14 In total, 4 cost-effectiveness analyses, 13,16,18,19 2 cost-utility analyses, 14,15 and 1 cost-benefit analysis 17 were found.…”

Section: Search Results and Narrative Synthesis Of Evidencementioning

confidence: 99%

“…15 Only 1 study performed the analysis with a vital horizon. 14 In total, 4 cost-effectiveness analyses, 13,16,18,19 2 cost-utility analyses, 14,15 and 1 cost-benefit analysis 17 were found. The main characteristics of the studies are shown in Table 1.…”

Section: Search Results and Narrative Synthesis Of Evidencementioning

confidence: 99%

See 3 more Smart Citations

Cost-Effectiveness of the Prenatal Detection of Congenital Heart Diseases: A Systematic Literature Review

Londoño Trujillo,

Castro García,

Rojas López

et al. 2024

JHEOR

View full text Add to dashboard Cite

Background: Congenital heart disease is the most common congenital condition worldwide, with a prevalence of 80 cases per 10 000 live births. In addition to perinatal morbidity and mortality, it entails long-term consequences such as multiple surgeries, prolonged hospitalizations, lifelong cardiac follow-up, reduced quality of life, risk of heart failure, and premature mortality in adulthood. This significant health and economic burden on healthcare systems and families highlights the relevance of evaluating the cost-effectiveness of methods for early detection of this condition. Objective: To conduct a systematic literature review (SLR) to identify and analyze existing economic evaluations on prenatal detection of congenital heart diseases through ultrasound, focusing on the reported cost-effectiveness results and the methodological quality of the evaluated studies according to established criteria. Methods: An SLR of economic evaluations was conducted following PRISMA guidelines. A quantitative synthesis of key methodological components of each economic evaluation was performed. The incremental medical costs, effectiveness measures, and cost-effectiveness ratios reported in each study were compiled and compared. The methodological quality was assessed according to compliance with the 24 CHEERS criteria. Results: We found 785 articles, of which only 7 met all inclusion criteria. Most were cost-effectiveness analyses, with the most common outcome being number of cases detected. Screening with only 4-chamber views interpreted by general practitioners or cardiologists were dominant strategies compared with screening with 4-chamber plus outflow views interpreted by a general practitioner. Fetal echocardiography was most effective but most expensive. Screening with 4-chamber and outflow view, followed by referral to a specialist, were recommended as the least expensive strategy per defect detected. On average, articles met 17 of the 24 CHEERS criteria. Discussion: While recent cost-effectiveness analyses demonstrated improved methodological quality, there was a lack of homogeneity due to differences in comparators and population subgroups analyzed. Despite this heterogeneity, fetal ultrasonography screening was consistently identified as a cost-effective strategy, with its cost-effectiveness heavily influenced by the expertise of the interpreting physician. Conclusion: Most studies recommend implementing obstetric ultrasonography screening, without routine fetal echocardiography, for detecting congenital heart diseases.

show abstract

Section: Search Results and Narrative Synthesis Of Evidencementioning

confidence: 99%

Section: Search Results and Narrative Synthesis Of Evidencementioning

confidence: 99%

Section: Search Results and Narrative Synthesis Of Evidencementioning

confidence: 99%

Section: Search Results and Narrative Synthesis Of Evidencementioning

confidence: 99%

See 2 more Smart Citations

Cost-Effectiveness of the Prenatal Detection of Congenital Heart Diseases: A Systematic Literature Review

Londoño Trujillo,

Castro García,

Rojas López

et al. 2024

JHEOR

View full text Add to dashboard Cite

show abstract

“…63 The cost-effectiveness of routine screening for CHD in pregnancies following IVF has also been questioned. 63,64 It is important to note that in this recent study by Chung et al 64 , universal fetal echocardiography in pregnancies achieved by IVF was associated with a higher detection rate of CHDs than with screening only when abnormal cardiac findings were noted on a detailed anatomy scan. Therefore, we suggest that fetal echocardiography be offered to patients with pregnancies achieved with IVF and ICSI (GRADE 2C).…”

Section: Are Congenital Anomalies Increased In Pregnancies Achieved W...mentioning

confidence: 85%

Society for Maternal-Fetal Medicine Consult Series #60: Management of pregnancies resulting from in vitro fertilization

Ghidini¹,

Gandhi²,

McCoy³

et al. 2022

American Journal of Obstetrics and Gynecology

View full text Add to dashboard Cite

Concordance Between Obstetric Anatomic Ultrasound and Fetal Echocardiography in Detecting Congenital Heart Disease in High‐risk Pregnancies

Rahul

Deal

Chisholm

et al. 2020

J of Ultrasound Medicine

View full text Add to dashboard Cite

Objectives To evaluate the concordance between second‐trimester anatomic ultrasound and fetal echocardiography in detecting minor and critical congenital heart disease in pregnancies meeting American Heart Association criteria. Methods We conducted a retrospective cohort study of pregnancies in which a second‐trimester fetal anatomic ultrasound examination (18–26 weeks) and fetal echocardiography were performed between 2012 and 2018 at our institution based on American Heart Association recommendations. Anatomic ultrasound studies were interpreted by maternal‐fetal medicine specialists and fetal echocardiographic studies by pediatric cardiologists. Our primary outcome was the proportion of critical congenital heart disease (CCHD) cases not detected by anatomic ultrasound but detected by fetal echocardiography. The secondary outcome was the proportion of total congenital heart disease cases missed by anatomic ultrasound but detected by fetal echocardiography. Neonatal medical records were reviewed for all pregnancies when obtained and available. Results Overall, 722 studies met inclusion criteria. Anatomic ultrasound and fetal echocardiography were in agreement in detecting cardiac abnormalities in 681(96.1%) studies (κ = 0.803; P < .001). The most common diagnosis not identified by anatomic ultrasound was a ventricular septal defect, accounting for 9 of 12 (75%) missed congenital heart defects. Of 664 studies with normal cardiac findings on the anatomic ultrasound examinations, no additional instances of CCHD were detected by fetal echocardiography. No unanticipated instances of CCHD were diagnosed postnatally. Conclusions With current American Heart Association screening guidelines, automatic fetal echocardiography in the setting of normal detailed anatomic ultrasound findings provided limited benefit in detecting congenital heart defects that would warrant immediate postnatal interventions. More selective use of automatic fetal echocardiography in at‐risk pregnancies should be explored.

show abstract

Cost‐effectiveness of prenatal screening methods for congenital heart defects in pregnancies conceived by in‐vitro fertilization

Cited by 10 publications

References 51 publications

Cost-Effectiveness of the Prenatal Detection of Congenital Heart Diseases: A Systematic Literature Review

Cost-Effectiveness of the Prenatal Detection of Congenital Heart Diseases: A Systematic Literature Review

Society for Maternal-Fetal Medicine Consult Series #60: Management of pregnancies resulting from in vitro fertilization

Concordance Between Obstetric Anatomic Ultrasound and Fetal Echocardiography in Detecting Congenital Heart Disease in High‐risk Pregnancies

Contact Info

Product

Resources

About