Please use this identifier to cite or link to this item: https://hdl.handle.net/2440/97360
Citations
Scopus Web of Science® Altmetric
?
?
Type: Journal article
Title: The cost-effectiveness of providing antenatal lifestyle advice for women who are overweight or obese: the LIMIT randomised trial
Author: Dodd, J.M.
Ahmed, S.
Karnon, J.
Umberger, W.
Deussen, A.R.
Tran, T.
Grivell, R.M.
Crowther, C.A.
Turnbull, D.
McPhee, A.J.
Wittert, G.
Owens, J.A.
Robinson, J.S.
Citation: BMC Obesity, 2015; 2(1):14-1-14-9
Publisher: BioMed Central
Issue Date: 2015
ISSN: 2052-9538
2052-9538
Statement of
Responsibility: 
Jodie M Dodd, Sharmina Ahmed, Jonathan Karnon, Wendy Umberger, Andrea R Deussen, Thach Tran, Rosalie M Grivell, Caroline A Crowther, Deborah Turnbull, Andrew J McPhee, Gary Wittert, Julie A Owens, Jeffrey S Robinson and For the LIMIT Randomised Trial Group
Abstract: BACKGROUND: Overweight and obesity during pregnancy is common, although robust evidence about the economic implications of providing an antenatal dietary and lifestyle intervention for women who are overweight or obese is lacking. We conducted a health economic evaluation in parallel with the LIMIT randomised trial. Women with a singleton pregnancy, between 10(+0)-20(+0) weeks, and BMI ≥25 kg/m(2) were randomised to Lifestyle Advice (a comprehensive antenatal dietary and lifestyle intervention) or Standard Care. The economic evaluation took the perspective of the health care system and its patients, and compared costs encountered from the additional use of resources from time of randomisation until six weeks postpartum. Increments in health outcomes for both the woman and infant were considered in the cost-effectiveness analysis. Mean costs and effects in the treatment groups allocated at randomisation were compared, and incremental cost effectiveness ratios (ICERs) and confidence intervals (95%) calculated. Bootstrapping was used to confirm the estimated confidence intervals, and to generate acceptability curves representing the probability of the intervention being cost-effective at alternative monetary equivalent values for the outcomes avoiding high infant birth weight, and respiratory distress syndrome. Analyses utilised intention to treat principles. RESULTS: Overall, the increase in mean costs associated with providing the intervention was offset by savings associated with improved immediate neonatal outcomes, rendering the intervention cost neutral (Lifestyle Advice Group $11261.19±$14573.97 versus Standard Care Group $11306.70±$14562.02; p=0.094). Using a monetary value of $20,000 as a threshold value for avoiding an additional infant with birth weight above 4 kg, the probability that the antenatal intervention is cost-effective is 0.85, which increases to 0.95 when the threshold monetary value increases to $45,000. CONCLUSIONS: Providing an antenatal dietary and lifestyle intervention for pregnant women who are overweight or obese is not associated with increased costs or cost savings, but is associated with a high probability of cost effectiveness. Ongoing participant follow-up into childhood is required to determine the medium to long-term impact of the observed, short-term endpoints, to more accurately estimate the value of the intervention on risk of obesity, and associated costs and health outcomes. TRIALS REGISTRATION: Australian and New Zealand Clinical Trials Registry (ACTRN12607000161426).
Keywords: LIMIT Randomised Trial Group
Pregnancy; Overweight and obesity; Health economics evaluation; Cost effectiveness analysis; Randomised trial; dietary and lifestyle intervention
Rights: © 2015 Dodd et al.; licensee BioMed Central. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
DOI: 10.1186/s40608-015-0046-4
Grant ID: http://purl.org/au-research/grants/nhmrc/519240
http://purl.org/au-research/grants/nhmrc/627005
http://purl.org/au-research/grants/nhmrc/1073514
Published version: http://dx.doi.org/10.1186/s40608-015-0046-4
Appears in Collections:Aurora harvest 3
Medicine publications

Files in This Item:
File Description SizeFormat 
hdl_97360.pdfPublished version632.65 kBAdobe PDFView/Open


Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.