{"id":58353,"date":"2023-02-16T13:19:10","date_gmt":"2023-02-16T18:19:10","guid":{"rendered":"https:\/\/www.healthynewbornnetwork.org\/?post_type=resource&p=58353"},"modified":"2023-02-16T13:19:10","modified_gmt":"2023-02-16T18:19:10","slug":"cost-effectiveness-of-low-dose-aspirin-for-the-prevention-of-preterm-birth","status":"publish","type":"resource","link":"https:\/\/www.healthynewbornnetwork.org\/resource\/cost-effectiveness-of-low-dose-aspirin-for-the-prevention-of-preterm-birth\/","title":{"rendered":"Cost-effectiveness of low-dose aspirin for the prevention of preterm birth: a prospective study of the Global Network for Women’s and Children’s Health Research"},"content":{"rendered":"

Background<\/p>\n

Premature birth is associated with an increased risk of mortality and morbidity, and strategies to prevent preterm birth are few in number and resource intensive. In 2020, the ASPIRIN trial showed the efficacy of low-dose aspirin (LDA) in nulliparous, singleton pregnancies for the prevention of preterm birth. We sought to investigate the cost-effectiveness of this therapy in low-income and middle-income countries.<\/div>\n

 <\/p>\n

Methods<\/p>\n

In this post-hoc, prospective, cost-effectiveness study, we constructed a probabilistic decision tree model to compare the benefits and costs of LDA treatment compared with standard care using primary data and published results from the ASPIRIN trial. In this analysis from a health-care sector perspective, we considered the costs and effects of LDA treatment, pregnancy outcomes, and neonatal health-care use. We did sensitivity analyses to understand the effect of the price of the LDA regimen, and the effectiveness of LDA in reducing both preterm birth and perinatal death.<\/div>\n

 <\/p>\n

Findings<\/p>\n

In model simulations, LDA was associated with 141 averted preterm births, 74 averted perinatal deaths, and 31 averted hospitalisations per 10\u2008000 pregnancies. The reduction in hospitalisation resulted in a cost of US$248 per averted preterm birth, $471 per averted perinatal death, and $15\u00b795 per disability-adjusted life year.<\/div>\n
<\/div>\n

Interpretation<\/p>\n

LDA treatment in nulliparous, singleton pregnancies is a low-cost, effective treatment to reduce preterm birth and perinatal death. The low cost per disability-adjusted life year averted strengthens the evidence in support of prioritising the implementation of LDA in publicly funded health care in low-income and middle-income countries.<\/div>\n","protected":false},"excerpt":{"rendered":"

Background Premature birth is associated with an increased risk of mortality and morbidity, and strategies to prevent preterm birth are few in number and resource intensive. In 2020, the ASPIRIN trial showed the efficacy of low-dose aspirin (LDA) in nulliparous, singleton pregnancies for the prevention of preterm birth. 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While many preterms survive in high-income countries, in low- and middle-income countries a lack of adequate newborn care puts the lives of many preterm babies at risk.[\/vc_column_text][\/vc_column][vc_column width=\"1\/2\" el_class=\"issue-stats\"][vc_row_inner content_placement=\"middle\"][vc_column_inner el_class=\"text-red\" width=\"1\/3\"][vc_column_text]\r\n<h1 style=\"text-align: center;\"><strong><span class=\"ticker\">15<\/span>m<\/strong><\/h1>\r\n[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"2\/3\"][vc_column_text css=\".vc_custom_1666023383014{padding-top: 10px !important;padding-bottom: 10px !important;}\"]\r\n<h3 style=\"text-align: center;\"><span style=\"font-weight: 400;\">number of babies born prematurely (2014)<\/span><\/h3>\r\n[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][vc_separator][vc_row_inner content_placement=\"middle\"][vc_column_inner el_class=\"text-yellow\" width=\"1\/3\"][vc_column_text]\r\n<h1 style=\"text-align: center;\"><strong><span class=\"ticker\">10.6<\/span><\/strong><\/h1>\r\n[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"2\/3\"][vc_column_text css=\".vc_custom_1666023354144{padding-top: 10px !important;padding-bottom: 10px !important;}\"]\r\n<h3 style=\"text-align: center;\"><span style=\"font-weight: 400;\">rate of premature babies worldwide (2014)<\/span><\/h3>\r\n[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][vc_separator][vc_row_inner content_placement=\"middle\"][vc_column_inner el_class=\"text-blue\" width=\"1\/3\"][vc_column_text]\r\n<h1 style=\"text-align: center;\"><strong><span class=\"ticker\">89<\/span><\/strong><\/h1>\r\n[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"2\/3\"][vc_column_text css=\".vc_custom_1667425699228{padding-top: 10px !important;padding-bottom: 10px !important;}\"]\r\n<h3 style=\"text-align: center;\"><span style=\"font-weight: 400;\">percentage of <a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC8850944\/pdf\/jogh-12-04011.pdf\">preterm births<\/a> that occur in sub-Saharan Africa and South-Asia (2012 - 2016)<\/span><\/h3>\r\n[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][vc_separator][vc_column_text]\r\n<h6 style=\"text-align: center;\"><em>All data on this page represents the most recent data available. Please visit our <a href=\"https:\/\/www.healthynewbornnetwork.org\/numbers\/\">Newborn Numbers<\/a> page and download the Excel spreadsheet to explore the data further.<\/em><\/h6>\r\n[\/vc_column_text][vc_empty_space][\/vc_column][\/vc_row][vc_row full_width=\"stretch_row\" css=\".vc_custom_1452696349804{margin-top: 30px !important;margin-bottom: 30px !important;background-color: #f6f6f4 !important;}\"][vc_column][vc_text_separator title=\"Preventing preterm birth\" color=\"custom\" accent_color=\"#cccccc\"][vc_column_text]\r\n<p style=\"text-align: center;\">Although we still do not have a full understanding of the causes of preterm birth, several interventions may reduce the risk of a woman delivering early, including high-quality\u00a0antenatal care; good nutrition; screening and management of maternal infections, diabetes, and hypertension; smoking cessation; family planning; and prenatal care for adolescents. If a woman presents in preterm labor, administration of antenatal corticosteroids may\u00a0reduce mortality from respiratory distress, and antibiotics can reduce a baby\u2019s risk for infection.<\/p>\r\n[\/vc_column_text][vc_column_text]<strong>Key resources:<\/strong>\r\n<ul>\r\n \t<li><a href=\"https:\/\/www.healthynewbornnetwork.org\/resource\/who-recommendations-for-care-of-the-preterm-or-low-birth-weight-infant\/\">WHO recommendations for care of the preterm or low-birth-weight newborn (2022)<\/a><\/li>\r\n \t<li><a href=\"https:\/\/www.healthynewbornnetwork.org\/resource\/joint-statement-international-recommendations-interventions-improve-preterm-birth-outcomes\/\" target=\"_blank\" rel=\"noopener noreferrer\">Joint Statement: International WHO Recommendations on Interventions to Improve Preterm Birth Outcomes<\/a><\/li>\r\n \t<li><a href=\"http:\/\/dx.doi.org\/10.1016\/S2214-109X(18)30565-5\">National, regional, and worldwide estimates of low birthweight in 2015, with trends from 2000: a systematic analysis<\/a><\/li>\r\n \t<li><a href=\"http:\/\/dx.doi.org\/10.1016\/S2214-109X(19)30041-5\">Low birthweight: will new estimates accelerate progress?<\/a><\/li>\r\n \t<li><a href=\"https:\/\/www.everypreemie.org\/wp-content\/uploads\/2019\/09\/Nurturing-Care-Evidence-Review-and-Case-Studies-13Aug2019.pdf\">Nurturing care for small and sick newborns: Evidence review and country case studies<\/a><\/li>\r\n \t<li><a href=\"https:\/\/www.everypreemie.org\/wp-content\/uploads\/2019\/07\/DNH_TechBrief_HumanMilkFeeding_7.9.19Final.pdf\">Safe and effective human milk feeding for small and sick newborns<\/a><\/li>\r\n \t<li><a href=\"https:\/\/www.nature.com\/articles\/pr2013204\">Preterm birth\u2013associated neurodevelopmental impairment estimates at regional and global levels for 2010<\/a><\/li>\r\n \t<li><a href=\"https:\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/BornTooSoon-Report-April2012.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">Born too soon<\/a><\/li>\r\n \t<li><a href=\"http:\/\/ptb.srhr.org\/\">Latest global, regional and national estimates of levels of preterm birth<\/a><\/li>\r\n \t<li><a href=\"https:\/\/www.thelancet.com\/series\/preterm-birth\" target=\"_blank\" rel=\"noopener noreferrer\">Lancet preterm birth series<\/a>\r\n<ul>\r\n \t<li><a href=\"http:\/\/www.thelancet.com\/journals\/lancet\/article\/PIIS0140-6736%2808%2960074-4\/abstract\" target=\"_blank\" rel=\"noopener noreferrer\">Epidemiology and causes of preterm birth<\/a><\/li>\r\n \t<li><a href=\"http:\/\/www.thelancet.com\/journals\/lancet\/article\/PIIS0140-6736%2808%2960108-7\/abstract\" target=\"_blank\" rel=\"noopener noreferrer\">Primary, secondary, and tertiary interventions to reduce the morbidity and mortality of preterm birth<\/a><\/li>\r\n \t<li><a href=\"http:\/\/www.thelancet.com\/journals\/lancet\/article\/PIIS0140-6736%2808%2960136-1\/abstract\" target=\"_blank\" rel=\"noopener noreferrer\">An overview of mortality and sequelae of preterm birth from infancy to adulthood<\/a><\/li>\r\n<\/ul>\r\n<\/li>\r\n \t<li><a href=\"https:\/\/www.who.int\/initiatives\/every-newborn-action-plan\" target=\"_blank\" rel=\"noopener noreferrer\">Every Newborn Action Plan<\/a><\/li>\r\n \t<li><a href=\"https:\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/9789241508988_eng.pdf\">WHO recommendations on interventions to improve preterm birth outcomes (2015)<\/a><\/li>\r\n<\/ul>\r\n[\/vc_column_text][\/vc_column][\/vc_row]","post_title":"Preterm birth complications","post_excerpt":"","post_status":"publish","comment_status":"closed","ping_status":"closed","post_password":"","post_name":"preterm-birth-complications","to_ping":"","pinged":"","post_modified":"2022-11-16 18:35:44","post_modified_gmt":"2022-11-16 23:35:44","post_content_filtered":"","post_parent":0,"guid":"http:\/\/www.healthynewbornnetwork.org\/?post_type=issue&p=310","menu_order":0,"post_type":"issue","post_mime_type":"","comment_count":"0","filter":"raw"}],"regions":[],"countries":[],"views":"324"},"_links":{"self":[{"href":"https:\/\/www.healthynewbornnetwork.org\/wp-json\/wp\/v2\/resource\/58353"}],"collection":[{"href":"https:\/\/www.healthynewbornnetwork.org\/wp-json\/wp\/v2\/resource"}],"about":[{"href":"https:\/\/www.healthynewbornnetwork.org\/wp-json\/wp\/v2\/types\/resource"}],"author":[{"embeddable":true,"href":"https:\/\/www.healthynewbornnetwork.org\/wp-json\/wp\/v2\/users\/7211"}],"replies":[{"embeddable":true,"href":"https:\/\/www.healthynewbornnetwork.org\/wp-json\/wp\/v2\/comments?post=58353"}],"version-history":[{"count":0,"href":"https:\/\/www.healthynewbornnetwork.org\/wp-json\/wp\/v2\/resource\/58353\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.healthynewbornnetwork.org\/wp-json\/wp\/v2\/media\/58355"}],"wp:attachment":[{"href":"https:\/\/www.healthynewbornnetwork.org\/wp-json\/wp\/v2\/media?parent=58353"}],"wp:term":[{"taxonomy":"toolkit","embeddable":true,"href":"https:\/\/www.healthynewbornnetwork.org\/wp-json\/wp\/v2\/toolkit?post=58353"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}