{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T17:45:21Z","timestamp":1775065521820,"version":"3.50.1"},"reference-count":27,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2015,12,10]],"date-time":"2015-12-10T00:00:00Z","timestamp":1449705600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100003514","name":"Kommunfullm\u00e4ktige, Stockholms Stad","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003514","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004047","name":"Karolinska Institutet","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004047","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2016,7]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To estimate the cost\u2010effectiveness of first trimester non\u2010invasive fetal <jats:italic><jats:styled-content style=\"fixed-case\">RHD<\/jats:styled-content><\/jats:italic> screening for targeted antenatal versus no routine antenatal anti\u2010D prophylaxis (<jats:styled-content style=\"fixed-case\">RAADP<\/jats:styled-content>) or versus non\u2010targeted <jats:styled-content style=\"fixed-case\">RAADP<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Model based on a population\u2010based cohort study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>The Swedish health service.<\/jats:p><\/jats:sec><jats:sec><jats:title>Population<\/jats:title><jats:p>Intervention subjects in the underlying cohort study were RhD\u2010negative pregnant women receiving first trimester fetal <jats:italic><jats:styled-content style=\"fixed-case\">RHD<\/jats:styled-content><\/jats:italic> screening followed by targeted anti\u2010D in 2010\u20132011 (<jats:italic>n<\/jats:italic>\u00a0=\u00a06723). Historical comparators were RhD\u2010negative women who delivered in 2008\u20132009 when standard care did not include <jats:styled-content style=\"fixed-case\">RAADP<\/jats:styled-content> (<jats:italic>n<\/jats:italic>\u00a0=\u00a07099).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Healthcare costs for the three strategies were included for the first and subsequent pregnancies. For the comparison with non\u2010targeted <jats:styled-content style=\"fixed-case\">RAADP<\/jats:styled-content>, the immunisation rate was based on the observed rate for targeted therapy and adjusted downwards by removing the influence of false negatives.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measure<\/jats:title><jats:p>Additional cost per RhD immunisation averted.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Compared with <jats:styled-content style=\"fixed-case\">RAADP<\/jats:styled-content>, targeted prophylaxis was associated with fewer immunisations (0.19 versus 0.46% per pregnancy) and lower costs (cost\u2010savings of \u20ac32 per RhD\u2010negative woman). The savings were from lower costs during pregnancy and delivery, and lower costs of future pregnancies through fewer immunisations. Non\u2010targeted anti\u2010D was estimated to result in 0.06% fewer immunisations and an additional \u20ac16 in cost\u2010savings per mother, compared with targeted anti\u2010D.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Based on effect data from a population\u2010based cohort study, targeted prophylaxis was associated with lower immunisation risk and costs versus no <jats:styled-content style=\"fixed-case\">RAADP<\/jats:styled-content>. Based on effect data from theoretical calculations, non\u2010targeted <jats:styled-content style=\"fixed-case\">RAADP<\/jats:styled-content> was predicted to result in lower costs and immunisation risk compared with targeted prophylaxis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Tweetable abstract<\/jats:title><jats:p>Fetal <jats:italic><jats:styled-content style=\"fixed-case\">RHD<\/jats:styled-content><\/jats:italic> screening and targeted prophylaxis resulted in lower immunisation risk and costs compared with no <jats:styled-content style=\"fixed-case\">RAADP<\/jats:styled-content>.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1471-0528.13801","type":"journal-article","created":{"date-parts":[[2015,12,10]],"date-time":"2015-12-10T21:28:15Z","timestamp":1449782895000},"page":"1337-1346","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Cost\u2010effectiveness of first trimester non\u2010invasive fetal <i><scp>RHD<\/scp><\/i> screening for targeted antenatal anti\u2010D prophylaxis in RhD\u2010negative pregnant women: a model\u2010based analysis"],"prefix":"10.1111","volume":"123","author":[{"given":"M","family":"Neovius","sequence":"first","affiliation":[{"name":"Department of Medicine Clinical Epidemiology Unit Karolinska Institutet Stockholm Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E","family":"Tiblad","sequence":"additional","affiliation":[{"name":"Obstetrics &amp; 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