Cost-Effectiveness of Fetal Fibronectin Testing in Women at Risk for Preterm Birth: A Retrospective Cohort Study

Area of Science:

• Obstetrics and Gynecology
• Health Economics
• Clinical Diagnostics

Background:

• Preterm birth is a significant concern, necessitating accurate identification of true preterm labor.
• The fetal fibronectin (fFN) test is a diagnostic tool used to predict the likelihood of preterm delivery.

Purpose of the Study:

• To evaluate the cost-effectiveness of fetal fibronectin (fFN) testing compared to no fFN testing.
• To assess the impact of fFN testing on identifying true preterm labor in at-risk pregnant women.

Main Methods:

• Retrospective cohort study of 519 women with preterm labor symptoms (24-34 weeks gestation).
• Comparison of outcomes between women who received fFN testing and those who did not.
• Decision-tree model to calculate the incremental cost-effectiveness ratio for successful delivery within 48 hours.

Main Results:

• The proportion of deliveries within 48 hours was significantly higher in the fFN testing group (94% vs. 80%, P<0.0001).
• fFN testing was associated with a cost saving of QAR6,470 (US$1,777) per successful delivery.
• Improved short-term clinical outcomes were observed with fFN testing.

Conclusions:

• fFN testing demonstrates cost-effectiveness and improves short-term clinical outcomes in managing preterm labor.
• Results should be interpreted cautiously due to the retrospective design and baseline differences between groups.