Other members of the Hypertension and Pre-eclampsia Intervention Trial At Term (HYPITAT) study group are listed in Supporting Information, Appendix S1.
An economic analysis of induction of labour and expectant monitoring in women with gestational hypertension or pre-eclampsia at term (HYPITAT trial)
Article first published online: 14 SEP 2010
© 2010 The Authors Journal compilation © RCOG 2010 BJOG An International Journal of Obstetrics and Gynaecology
BJOG: An International Journal of Obstetrics & Gynaecology
Volume 117, Issue 13, pages 1577–1585, December 2010
How to Cite
Vijgen, S., Koopmans, C., Opmeer, B., Groen, H., Bijlenga, D., Aarnoudse, J., Bekedam, D., van den Berg, P., de Boer, K., Burggraaff, J., Bloemenkamp, K., Drogtrop, A., Franx, A., de Groot, C., Huisjes, A., Kwee, A., van Loon, A., Lub, A., Papatsonis, D., van der Post, J., Roumen, F., Scheepers, H., Stigter, R., Willekes, C., Mol, B., Van Pampus, M. and for the HYPITAT study group (2010), An economic analysis of induction of labour and expectant monitoring in women with gestational hypertension or pre-eclampsia at term (HYPITAT trial). BJOG: An International Journal of Obstetrics & Gynaecology, 117: 1577–1585. doi: 10.1111/j.1471-0528.2010.02710.x
- Issue published online: 15 NOV 2010
- Article first published online: 14 SEP 2010
- Accepted 21 June 2010. Published Online 14 September 2010.
- expectant monitoring;
- gestational hypertension;
- induction of labour;
Please cite this paper as: Vijgen S, Koopmans C, Opmeer B, Groen H, Bijlenga D, Aarnoudse J, Bekedam D, van den Berg P, de Boer K, Burggraaff J, Bloemenkamp K, Drogtrop A, Franx A, de Groot C, Huisjes A, Kwee A, van Loon A, Lub A, Papatsonis D, van der Post J, Roumen F, Scheepers H, Stigter R, Willekes C, Mol B, Van Pampus M for the HYPITAT study group. An economic analysis of induction of labour and expectant monitoring in women with gestational hypertension or pre-eclampsia at term (HYPITAT trial). BJOG 2010;117:1577–1585.
Objective To assess the economic consequences of labour induction compared with expectant monitoring in women with gestational hypertension or pre-eclampsia at term.
Design An economic analysis alongside the Hypertension and Pre-eclampsia Intervention Trial At Term (HYPITAT).
Setting Obstetric departments of six university and 32 teaching and district hospitals in the Netherlands.
Population Women diagnosed with gestational hypertension or pre-eclampsia between 36+0 and 41+0 weeks of gestation, randomly allocated to either induction of labour or expectant monitoring.
Methods A trial-based cost-effectiveness analysis was performed from a societal perspective during a 1-year time horizon.
Main outcome measures One-year costs were estimated and health outcomes were expressed as the prevalence of poor maternal outcome defined as either maternal complications or progression to severe disease.
Results The average costs of induction of labour (n = 377) were €7077 versus €7908 for expectant monitoring (n = 379), with an average difference of −€831 (95% CI −€1561 to −€144). This 11% difference predominantly originated from the antepartum period: per woman costs were €1259 for induction versus €2700 for expectant monitoring. During delivery, more costs were generated following induction (€2190) compared with expectant monitoring (€1210). No substantial differences were found in the postpartum, follow-up and for non-medical costs.
Conclusion In women with gestational hypertension or mild pre-eclampsia at term, induction of labour is less costly than expectant monitoring because of differences in resource use in the antepartum period. As the trial already demonstrated that induction of labour results in less progression to severe disease without resulting in a higher caesarean section rate, both clinical and economic consequences are in favour of induction of labour in these women.
Trial registration The trial has been registered in the clinical trial register as ISRCTN08132825.