{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,8]],"date-time":"2025-11-08T18:09:05Z","timestamp":1762625345756,"version":"3.40.5"},"reference-count":36,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2024,11,28]],"date-time":"2024-11-28T00:00:00Z","timestamp":1732752000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001826","name":"ZonMw","doi-asserted-by":"publisher","award":["836041006"],"award-info":[{"award-number":["836041006"]}],"id":[{"id":"10.13039\/501100001826","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Gynecology &amp; Obste"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>To assess the cost\u2010effectiveness of low\u2010dose aspirin compared to placebo for the prevention of recurrent preterm birth from a healthcare perspective. This was a cost\u2010effectiveness analysis alongside a multicenter, randomized, double\u2010blinded, placebo\u2010controlled trial. We included women with a singleton pregnancy and a previous spontaneous preterm birth &lt;37\u2009weeks of gestation of a singleton. Women were randomized between aspirin 80\u2009mg daily and placebo, initiated between 8 and 16\u2009weeks of gestation. We estimated the difference in preterm births (&lt;37\u2009weeks of gestation), and maternal and neonatal healthcare costs using seemingly unrelated linear regression analyses. Bootstrapping was performed to estimate statistical uncertainty. A total of 387 women were included: 194 in the aspirin group and 193 in the placebo group. We observed a small, statistically non\u2010significant difference in preterm birth (21.2% vs. 25.4%; risk difference \u22124.3%; 95% CI: \u221212.7% to 4.1%) and healthcare costs (mean \u2013\u20ac99; 95% CI: \u2013\u20ac2385 to \u20ac2325) in the aspirin group compared to placebo. The cost\u2010effectiveness acceptability curve showed that the probability of aspirin being cost\u2010effective was 54% for a willingness to pay threshold of \u20ac0 for one prevented preterm birth and 78% for \u20ac50\u2009000 for one prevented preterm birth. Our findings suggest that aspirin is the dominant strategy over placebo for the prevention of preterm birth. However, there was substantial uncertainty around the results and definite conclusions regarding the cost\u2010effectiveness of aspirin cannot be drawn.<\/jats:p>","DOI":"10.1002\/ijgo.16024","type":"journal-article","created":{"date-parts":[[2024,11,28]],"date-time":"2024-11-28T10:57:24Z","timestamp":1732791444000},"page":"399-407","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Cost\u2010effectiveness of a randomized controlled trial comparing low\u2010dose aspirin to placebo for the prevention of recurrent preterm birth"],"prefix":"10.1002","volume":"169","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6354-3489","authenticated-orcid":false,"given":"Anadeijda J. E. M. C.","family":"Landman","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology Amsterdam UMC location Vrije Universiteit Amsterdam  Amsterdam The Netherlands"},{"name":"Amsterdam Reproduction and Development Research Institute  Amsterdam The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1662-3005","authenticated-orcid":false,"given":"Hana M.","family":"Broulikova","sequence":"additional","affiliation":[{"name":"Faculty of Science, Department of Health Sciences, Amsterdam Public Health Research Institute Vrije Universiteit Amsterdam  Amsterdam The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura","family":"Visser","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Amsterdam UMC location Vrije Universiteit Amsterdam  Amsterdam The Netherlands"},{"name":"Amsterdam Reproduction and Development Research Institute  Amsterdam The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2620-8884","authenticated-orcid":false,"given":"Tobias A. J.","family":"Nijman","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology University Medical Center Utrecht  Utrecht The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marieke A. C.","family":"Hemels","sequence":"additional","affiliation":[{"name":"Department of Neonatal Intensive Care Isala  Zwolle The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karin C.","family":"Vollebregt","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Spaarne Gasthuis  Haarlem The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elisabeth M. A.","family":"Boormans","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Meander Medical Center  Amersfoort The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Henk A.","family":"Bremer","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Reinier de Graaf Gasthuis  Delft The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Esther","family":"Tuinman","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Treant Zorggroep, Bethesda Hospital  Hoogeveen The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0107-2332","authenticated-orcid":false,"given":"Josje","family":"Langenveld","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Zuyderland Medical Center  Heerlen The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2327-7104","authenticated-orcid":false,"given":"Flip","family":"van der Made","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Franciscus Gasthuis and Vlietland  Rotterdam The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robbert J. P.","family":"Rijnders","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Jeroen Bosch Hospital  Den Bosch The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3709-9633","authenticated-orcid":false,"given":"Huib A. A. M.","family":"van Vliet","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Catharina Hospital  Eindhoven The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0129-8251","authenticated-orcid":false,"given":"Liv M.","family":"Freeman","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Ikazia Hospital  Rotterdam The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7170-7543","authenticated-orcid":false,"given":"Roel","family":"de Heus","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology St. Antonius Hospital  Utrecht The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Judith","family":"Blaauw","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Ommelander Hospital Group  Groningen The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ineke","family":"Krabbendam","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Gelderse Vallei Hospital  Ede The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7194-2797","authenticated-orcid":false,"given":"Rafli","family":"van de Laar","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology VieCuri Medical Center  Venlo The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4501-4855","authenticated-orcid":false,"given":"Marieke F. 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