在怀孕期间治疗轻度慢性高血压:成本效益分析
Uma Doshi1, Sarina Chaiken, Alyssa Hersh
1Department of Obstetrics and Gynecology, Oregon Health & Science University, Portland, Oregon.
Obstetrics and gynecology
|February 22, 2024
概括
在怀孕期间以较轻的血压目标 (140/90 mm Hg) 治疗慢性高血压是一种具有成本效益的战略. 这种方法可以减少孕产妇和新生儿的并发症和死亡,同时降低医疗保健成本.
科学领域:
- 产科和妇科 产科和妇科
- 心脏病学 心脏病学
- 卫生经济学 卫生经济学
背景情况:
- 怀孕期间的慢性高血压对母亲和胎儿都有很大的风险.
- 目前的治疗指南各不相同,有些人主张在干预之前提高血压值.
研究的目的:
- 为了评估较低的血压目标 (小于140/90毫米) 与更高的目标 (160/105毫米) 在怀孕期间管理慢性高血压的成本效益.
主要方法:
- 一个决策分析模型模拟了18万名患有慢性高血压的孕妇的结果.
- 关于概率,成本和质量调整寿命年 (QALYs) 的数据是从文献中获得的,并通过灵敏度分析进行分析.
- 关键结局包括子前症,严重的孕产妇发病率,早产,孕产妇/新生儿死亡和神经发育迟缓.
主要成果:
- 针对较低血压的治疗显著减少了孕前症 (14,177例减少) 和严重的孕产妇发病率 (817例减少).
- 这一策略还减少了孕产妇死亡率 (18人减少),早产 (8,078人减少) 和新生儿死亡率 (26人减少).
- 较低门方法是占主导地位的策略,节省了6亿美元,QALY增加了12852.2.
结论:
- 在怀孕期间以140/90毫米值治疗慢性高血压是一种占主导地位且具有成本效益的策略.
- 这种方法导致改善母亲和新生儿的结果,包括降低死亡率,相比治疗在更高的血压范围.
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