School of Medicine and Public Health, The University of Newcastle, University Drive, Callaghan, NSW, Australia.
Hunter Medical Research Institute (HMRI), Lot 1, Kookaburra Circuit, New Lambton Heights, NSW, Australia.
Nutr Rev. 2021 Feb 11;79(3):261-273. doi: 10.1093/nutrit/nuaa015.
Improving maternal nutrition and promoting alcohol abstinence during pregnancy are key to reducing subsequent economic and social impacts. However, antenatal nutrition and alcohol interventions are underused, partly because economic evidence to support investment is limited.
The purpose of this systematic literature review was to assess the extent to which economic evaluations have been applied to antenatal public health interventions, and implementation strategies addressing maternal nutrition and alcohol intake.
Two separate systematic reviews were conducted to address the 2 stated aims. Both reviews adhered to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The searches were conducted using the following databases: Medline, EMBASE, Cochrane, EconLit, CINAHL, and the National Health Service Economic Evaluation Database, accompanied by a handsearch of gray literature.
Review 1 returned 9599 records after duplicates were removed, from which 12 economic evaluations were included. Review 2 returned 136 records after duplicates were removed, with none eligible for inclusion. The articles included in review 1 comprised 10 economic evaluations of nutrition interventions and 2 evaluations of alcohol interventions.
Methodological quality was assessed using the Drummond 10-point quality checklist. Methodological quality was high, with variation in reporting practices and predominance of modeled evaluations.
Antenatal nutrition and alcohol interventions offer value for money and have potential to considerably reduce healthcare costs. No evidence regarding intervention implementation cost was identified.
The current evidence base has important gaps that limit its value to decision makers. Incorporating health economic principles and methods into health promotion interventions will inform decisions about how to derive value from investment in healthcare.
改善孕产妇营养并提倡孕妇戒酒是减少后续经济和社会影响的关键。然而，产前营养和酒精干预措施的应用不足，部分原因是支持投资的经济证据有限。
本系统文献综述的目的是评估经济评估在多大程度上应用于产前公共卫生干预措施，以及针对孕产妇营养和酒精摄入的实施策略。
为了实现这两个目标，分别进行了两次系统综述。这两项综述均遵循 PRISMA（系统评价和荟萃分析的首选报告项目）指南。使用以下数据库进行了搜索：Medline、EMBASE、Cochrane、EconLit、CINAHL 和国家卫生服务经济评估数据库，并辅以灰色文献的手工搜索。
综述 1 在去除重复项后返回了 9599 条记录，其中包括 12 项经济评估。综述 2 在去除重复项后返回了 136 条记录，但没有符合纳入标准的记录。综述 1 中包含的文章包括 10 项营养干预措施的经济评估和 2 项酒精干预措施的评估。
使用 Drummond 10 分质量检查表评估方法学质量。方法学质量较高，但报告实践存在差异，且以模型评估为主。
产前营养和酒精干预措施具有成本效益，并有潜力大大降低医疗保健成本。没有发现关于干预实施成本的证据。
当前的证据基础存在重要的空白，限制了其对决策者的价值。将健康经济原则和方法纳入健康促进干预措施将为如何从医疗保健投资中获得价值提供信息。
