Department of Obstetrics, University of California, CA, USA.
Am J Obstet Gynecol. 2011 Sep;205(3):282.e1-7. doi: 10.1016/j.ajog.2011.06.051. Epub 2011 Jun 21.
This study investigated the cost-effectiveness of treating mild gestational diabetes mellitus (GDM).
A decision analytic model was built to compare treating vs not treating mild GDM. The primary outcome was the incremental cost per quality-adjusted life year (QALY). All probabilities, costs, and benefits were derived from the literature. Base case, sensitivity analyses, and a Monte Carlo simulation were performed.
Treating mild GDM was more expensive, more effective, and cost-effective at $20,412 per QALY. Treatment remained cost-effective when the incremental cost to treat GDM was less than $3555 or if treatment met at least 49% of its reported efficacy at the baseline cost to treat of $1786.
Treating mild GDM is cost-effective in terms of improving maternal and neonatal outcomes including decreased rates of preeclampsia, cesarean sections, macrosomia, shoulder dystocia, permanent and transient brachial plexus injury, neonatal hypoglycemia, neonatal hyperbilirubinemia, and neonatal intensive care unit admissions.
本研究旨在探讨治疗轻度妊娠糖尿病（GDM）的成本效益。
建立了一个决策分析模型来比较治疗与不治疗轻度 GDM。主要结果是每质量调整生命年（QALY）的增量成本。所有的概率、成本和效益均来自文献。进行了基础案例、敏感性分析和蒙特卡罗模拟。
治疗轻度 GDM 的费用更高，但效果更好，每 QALY 的成本效益为 20412 美元。当治疗 GDM 的增量成本低于 3555 美元，或者当治疗在基线治疗成本 1786 美元下至少达到其报告疗效的 49%时，治疗仍然具有成本效益。
治疗轻度 GDM 在改善母婴结局方面具有成本效益，包括降低子痫前期、剖宫产、巨大儿、肩难产、永久性和暂时性臂丛神经损伤、新生儿低血糖、新生儿高胆红素血症和新生儿重症监护病房入院率的发生率。
