{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T04:57:29Z","timestamp":1792040249944,"version":"4.4.0"},"reference-count":62,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2023,10,3]],"date-time":"2023-10-03T00:00:00Z","timestamp":1696291200000},"content-version":"vor","delay-in-days":2,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet &amp;amp; Gyne"],"published-print":{"date-parts":[[2023,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To assess the effectiveness, cost and cost\u2010effectiveness of four screening strategies for first\u2010trimester (T1) cytomegalovirus (CMV) primary infection (PI) in pregnant women in France.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In a simulated pregnant population of 800\u2009000 (approximate number of pregnancies each year in France), using costs based on the year 2022, we compared four CMV maternal screening strategies: Strategy\u2009S1, no systematic screening (current public health recommendations in France); Strategy\u2009S2, screening of 25\u201350% of the pregnant population (current screening practice in France); Strategy\u2009S3, universal screening (current medical recommendations in France); Strategy\u2009S4, universal screening (as in Strategy\u2009S3) in conjunction with valacyclovir in case of T1\u2009PI. Outcomes were total cost, effectiveness (number of congenital infections, number of diagnosed infections) and incremental cost\u2010effectiveness ratio (ICER). Two ICERs were calculated, comparing Strategies\u2009S1, S2 and S3 in terms of euros (\u20ac) per additional diagnosis, and comparing Strategies\u2009S1 and S4 in \u20ac per avoided congenital infection.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Compared with Strategy S1, Strategy\u2009S3 enabled diagnosis of 536 more infected fetuses and Strategy\u2009S4 prevented 375 congenital infections. Strategy\u2009S1 was the least expensive strategy (\u20ac98.3m total lifetime cost), followed by Strategy\u2009S4 (\u20ac98.6m), Strategy\u2009S2 (\u20ac106.0m) and Strategy\u2009S3 (\u20ac118.9m). In the first analysis, Strategy\u2009S2 was dominated and Strategy\u2009S3 led to an additional \u20ac38\u2009552 per additional <jats:italic>in\u2010utero<\/jats:italic> diagnosis, compared with Strategy\u2009S1. In the second analysis, Strategy\u2009S4 led to an additional \u20ac893 per avoided congenital infection compared with Strategy\u2009S1, and was cost\u2010saving compared with Strategy\u2009S2.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In France, current screening practice for CMV PI during pregnancy is no longer acceptable in terms of cost\u2010effectiveness because this strategy was dominated by universal screening. Moreover, universal screening in conjunction with valacyclovir treatment  would be cost\u2010effective compared with current recommendations and is cost\u2010saving compared with current practice. \u00a9 2023 The Authors. <jats:italic>Ultrasound in Obstetrics &amp; Gynecology<\/jats:italic> published by John Wiley &amp; Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.<\/jats:p><\/jats:sec>","DOI":"10.1002\/uog.26226","type":"journal-article","created":{"date-parts":[[2023,4,26]],"date-time":"2023-04-26T17:30:26Z","timestamp":1682530226000},"page":"573-584","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":31,"title":["Cost\u2010effectiveness of screening and valacyclovir\u2010based treatment strategies for first\u2010trimester cytomegalovirus primary infection in pregnant women in France"],"prefix":"10.1002","volume":"62","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4711-5852","authenticated-orcid":false,"given":"C.","family":"P\u00e9rillaud\u2010Dubois","sequence":"first","affiliation":[{"name":"Universit\u00e9 Paris Cit\u00e9 and Universit\u00e9 Sorbonne Paris Nord, Inserm, IAME  Paris France"},{"name":"Virology Laboratory Sorbonne Universit\u00e9, H\u00f4pital Saint\u2010Antoine, AP\u2010HP  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N.","family":"Hachicha\u2010Maalej","sequence":"additional","affiliation":[{"name":"Universit\u00e9 Paris Cit\u00e9 and Universit\u00e9 Sorbonne Paris Nord, Inserm, IAME  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Lepers","sequence":"additional","affiliation":[{"name":"Universit\u00e9 Paris Cit\u00e9 and Universit\u00e9 Sorbonne Paris Nord, Inserm, IAME  Paris 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