Sutherland Tori, Bishai David M
Department of Obstetrics and Gynecology, Johns Hopkins Bayview Medical Center, Baltimore, Maryland 21224-2780, USA.
Int J Gynaecol Obstet. 2009 Mar;104(3):189-93. doi: 10.1016/j.ijgo.2008.10.011. Epub 2008 Dec 11.
To determine the cost-effectiveness of prenatal iron supplementation and misoprostol use as interventions to prevent maternal mortality in home births in rural India.
A cost-effectiveness analysis depicted three hypothetical cohorts of 10,000 pregnant women delivering at home in rural India: one with no intervention, one receiving standard prenatal iron supplements, and 1 receiving 600 microg of misoprostol in the third stage of labor.
Misoprostol used to prevent postpartum hemorrhage resulted in a 38% (95% CI, 5%-73%) decrease in maternal deaths, while prenatal iron supplementation resulted in a 5% (95% CI, 0%-47%) decrease. Misoprostol cost a median US $1401 (IQR US $1008-$1848) prenatal iron supplementation cost a median US $2241 (IQR No Lives Saved-$3882) per life saved compared with the standard care outcome.
Misoprostol is a cost-effective maternal mortality intervention for home births. Iron supplementation may be worthwhile to improve women's health, but it is uncertain whether it can prevent mortality after hemorrhage.
确定产前补充铁剂和使用米索前列醇作为预防印度农村地区家庭分娩产妇死亡干预措施的成本效益。
一项成本效益分析描绘了三组假设的队列，每组有10,000名在印度农村家庭分娩的孕妇：一组不进行干预，一组接受标准产前铁剂补充，另一组在分娩第三阶段接受600微克米索前列醇。
用于预防产后出血的米索前列醇使产妇死亡人数减少了38%（95%置信区间，5%-73%），而产前补充铁剂使产妇死亡人数减少了5%（95%置信区间，0%-47%）。与标准护理结果相比，每挽救一条生命，米索前列醇的成本中位数为1401美元（四分位间距为1008美元-1848美元），产前补充铁剂的成本中位数为2241美元（四分位间距为无生命挽救-3882美元）。
米索前列醇是一种用于家庭分娩的具有成本效益的产妇死亡干预措施。补充铁剂可能对改善妇女健康有益，但不确定它是否能预防出血后的死亡。
