Combined first-trimester versus second-trimester serum screening for Down syndrome: A cost analysis

Objective: The purpose of this study was to compare the cost-effectiveness of combined first-trimester screening for fetal Down syndrome with second-trimester maternal serum triple screening. Study Design: A first-trimester screening approach that used nuchal translucency measurement and maternal se...

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Bibliographic Details
Published in:American journal of obstetrics and gynecology 2003-03, Vol.188 (3), p.745-751
Main Authors: Cusick, William, Buchanan, Philip, Hallahan, Terrence W., Krantz, David A, Larsen, John W., Macri, James N.
Format: Article
Language:English
Subjects:
Adult
Biological and medical sciences
Cost-Benefit Analysis
Cost-effectiveness
Down Syndrome - diagnosis
Down Syndrome - economics
Female
fetal Down syndrome
Gynecology. Andrology. Obstetrics
Health Care Costs
Humans
Management. Prenatal diagnosis
Mass Screening - economics
Mass Screening - methods
Medical sciences
Neck - embryology
nuchal translucency
Pregnancy - blood
Pregnancy Trimester, First
Pregnancy Trimester, Second
Pregnancy. Fetus. Placenta
prenatal screening
serum screening
Ultrasonography, Prenatal
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Summary:Objective: The purpose of this study was to compare the cost-effectiveness of combined first-trimester screening for fetal Down syndrome with second-trimester maternal serum triple screening. Study Design: A first-trimester screening approach that used nuchal translucency measurement and maternal serum screening was evaluated against second-trimester maternal serum triple screening in a hypothetic population. Screening sensitivities and screen-positive rates were 91% and 5% for the first-trimester approach and 70% and 7.5% for the second-trimester approach, respectively. The costs of fetal Down syndrome, live-born Down syndrome cost, and total costs (screening plus live-born costs) were calculated for each screening program. Results: First-trimester screening was associated with lower screening and live-born Down syndrome costs versus second-trimester serum screening. Total Down syndrome screening costs were 29.1% lower with first-trimester screening. Conclusion: In this hypothetic model, combined first-trimester screening for fetal Down syndrome was more cost-effective than universal second-trimester triple serum screening. (Am J Obstet Gynecol 2003;188:745-51.)
ISSN:0002-9378
1097-6868
DOI:10.1067/mob.2003.127