{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T11:19:48Z","timestamp":1773227988396,"version":"3.50.1"},"reference-count":20,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2017,3,16]],"date-time":"2017-03-16T00:00:00Z","timestamp":1489622400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Research for Patient Benefit Programme of the National Institute for Health Research","award":["PB-PG-0610-22275"],"award-info":[{"award-number":["PB-PG-0610-22275"]}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2017,5]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Induction of labour at 39\u00a0weeks for nulliparous women aged 35\u00a0years and over may prevent stillbirths and does not increase caesarean births, so it may be popular. But the overall costs and benefits of such a policy have not been compared.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>A cost\u2013utility analysis alongside a randomised controlled trial (the 35\/39 trial).<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Obstetric departments of 38 <jats:styled-content style=\"fixed-case\">UK<\/jats:styled-content> National Health Service hospitals and one <jats:styled-content style=\"fixed-case\">UK<\/jats:styled-content> primary\u2010care trust.<\/jats:p><\/jats:sec><jats:sec><jats:title>Population<\/jats:title><jats:p>Nulliparous women aged 35\u00a0years or over on their expected due date, with a singleton live fetus in a cephalic presentation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Costs were estimated from the National Health Service and Personal Social Services perspective and quality\u2010adjusted life\u2010years (<jats:styled-content style=\"fixed-case\">QALY<\/jats:styled-content>s) were calculated based on patient responses to the <jats:styled-content style=\"fixed-case\">EQ<\/jats:styled-content>\u20105D at baseline and 4\u00a0weeks.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measures<\/jats:title><jats:p>Data on antenatal care, mode of delivery, analgesia in labour, method of induction, <jats:styled-content style=\"fixed-case\">EQ<\/jats:styled-content>\u20105D (baseline and 4\u00a0weeks postnatal) and participant\u2010administered postnatal health resource use data were collected.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The intervention was associated with a mean cost saving of \u00a3263 and a small additional gain in <jats:styled-content style=\"fixed-case\">QALY<\/jats:styled-content>s (though this was not statistically significant), even without considering any possible <jats:styled-content style=\"fixed-case\">QALY<\/jats:styled-content> gains from stillbirth prevention.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>A policy of induction of labour at 39\u00a0weeks for women of advanced maternal age would save money.<\/jats:p><\/jats:sec><jats:sec><jats:title>Tweetable abstract<\/jats:title><jats:p>A policy of induction of labour at 39\u00a0weeks of gestation for women of advanced maternal age would save money.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1471-0528.14557","type":"journal-article","created":{"date-parts":[[2017,1,11]],"date-time":"2017-01-11T15:40:07Z","timestamp":1484149207000},"page":"929-934","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":24,"title":["Labour induction near term for women aged 35 or over: an economic evaluation"],"prefix":"10.1111","volume":"124","author":[{"given":"KF","family":"Walker","sequence":"first","affiliation":[{"name":"Obstetrics and Gynaecology, Clinical Sciences University of Nottingham Nottingham 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