{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T23:28:57Z","timestamp":1790378937671,"version":"4.1.0"},"reference-count":36,"publisher":"Public Library of Science (PLoS)","issue":"6","license":[{"start":{"date-parts":[[2022,6,28]],"date-time":"2022-06-28T00:00:00Z","timestamp":1656374400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100011033","name":"thermo fisher scientific","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100011033","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\"><jats:title>Objective<\/jats:title><jats:p>To assess the cost-effectiveness of preterm preeclampsia (PE) screening versus routine screening based on maternal characteristics in Germany and Switzerland.<\/jats:p><\/jats:sec><jats:sec id=\"sec002\"><jats:title>Methods<\/jats:title><jats:p>A health economic model was used to analyse the cost-effectiveness of PE screening versus routine screening based on maternal characteristics. The analysis was conducted from the healthcare perspective with a time horizon of one year from the start of pregnancy. The main outcome measures were incremental health care costs and incremental costs per PE case averted.<\/jats:p><\/jats:sec><jats:sec id=\"sec003\"><jats:title>Results<\/jats:title><jats:p>The incremental health care costs for PE screening versus routine screening per woman were \u20ac14 in Germany, and -CHF42 in Switzerland, the latter representing cost savings. In Germany, the incremental costs per PE case averted were \u20ac3,795. In Switzerland, PE screening was dominant. The most influential parameter in the one-way sensitivity analysis was the cost of PE screening (Germany) and the probability of preterm PE in routine screening (Switzerland). In Germany, at a willingness-to-pay for one PE case avoided of \u20ac4,200, PE screening had a probability of more than 50% of being cost-effective compared to routine screening. In Switzerland, at a willingness-to-pay of CHF0, PE screening had a 78% probability of being the most cost-effective screening strategy.<\/jats:p><\/jats:sec><jats:sec id=\"sec004\"><jats:title>Conclusion<\/jats:title><jats:p>For Switzerland, PE screening is expected to be cost saving in comparison to routine screening. For Germany, the additional health care costs per woman were expected to be \u20ac14. Future cost-effectiveness studies should be conducted with a longer time horizon.<\/jats:p><\/jats:sec>","DOI":"10.1371\/journal.pone.0270490","type":"journal-article","created":{"date-parts":[[2022,6,28]],"date-time":"2022-06-28T18:33:39Z","timestamp":1656441219000},"page":"e0270490","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":12,"title":["Cost-effectiveness analysis of implementing screening on preterm pre-eclampsia at first trimester of pregnancy in Germany and Switzerland"],"prefix":"10.1371","volume":"17","author":[{"given":"Janne C.","family":"Mewes","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melanie","family":"Lindenberg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5539-4671","authenticated-orcid":true,"given":"Hubertus J. 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O\u2019Gorman","year":"2017","journal-title":"Ultrasound Obstet Gynecol"},{"issue":"1","key":"pone.0270490.ref007","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1159\/000341264","article-title":"Competing Risks Model in Early Screening for Preeclampsia by Biophysical and Biochemical Markers.","volume":"33","author":"R Akolekar","year":"2013","journal-title":"Fetal Diagnosis and Therapy"},{"key":"pone.0270490.ref008","article-title":"Expertenbrief No 57 Risikospezifizierung Pr\u00e4eklampsie im 1.","author":"S Tercanli","year":"2019","journal-title":"Trimester"},{"key":"pone.0270490.ref009","volume-title":"Richtlinien des Gemeinsamen Bundesausschusses \u00fcber die \u00e4rztliche Betreuung w\u00e4hrend der Schwangerschaft und nach der Entbindung (\u201eMutterschafts-Richtlinien\u201c).","author":"Gemeinsamer Bundesausschuss","year":"2020"},{"key":"pone.0270490.ref010","volume-title":"Informationsschreiben: Leistungen bei Mutterschaft und Kostenbeteiligung","author":"Bundesamt f\u00fcr Gesundheit","year":"2018"},{"issue":"4","key":"pone.0270490.ref011","doi-asserted-by":"crossref","first-page":"492","DOI":"10.1002\/uog.18816","article-title":"ASPRE trial: performance of screening for preterm pre-eclampsia.","volume":"50","author":"DL Rolnik","year":"2017","journal-title":"Ultrasound Obstet Gynecol"},{"issue":"2","key":"pone.0270490.ref012","doi-asserted-by":"crossref","first-page":"186","DOI":"10.1002\/uog.19112","article-title":"Screening for pre-eclampsia by maternal factors and biomarkers at 11\u201313\u2009weeks\u2019 gestation.","volume":"52","author":"MA-O Tan","year":"2018","journal-title":"Ultrasound Obstet Gynecol"},{"issue":"369","key":"pone.0270490.ref013","doi-asserted-by":"crossref","first-page":"1791","DOI":"10.1016\/S0140-6736(07)60712-0","article-title":"Antiplatelet agents for prevention of pre-eclampsia: a meta-analysis of individual patient data","volume":"26","author":"LM Askie","year":"2007","journal-title":"Lancet"},{"key":"pone.0270490.ref014","doi-asserted-by":"crossref","first-page":"579293","DOI":"10.3389\/fped.2020.579293","article-title":"Neonatal Outcome After Preeclampsia and HELLP Syndrome: A Population-Based Cohort Study in Germany.","volume":"8","author":"V Bossung","year":"2020","journal-title":"Front Pediatr"},{"issue":"2","key":"pone.0270490.ref015","doi-asserted-by":"crossref","first-page":"E508","DOI":"10.9778\/cmajo.20160092","article-title":"Estimated reductions in provider-initiated preterm births and hospital length of stay under a universal acetylsalicylic acid prophylaxis strategy: a retrospective cohort study.","volume":"5","author":"JG Ray","year":"2017","journal-title":"CMAJ Open"},{"issue":"9","key":"pone.0270490.ref016","doi-asserted-by":"crossref","first-page":"926","DOI":"10.1080\/13696998.2020.1775619","article-title":"Preeclampsia in Switzerland: a cost analysis in two hospitals.","volume":"23","author":"M Hodel","year":"2020","journal-title":"J Med Econ"},{"key":"pone.0270490.ref017","volume-title":"Lebendgeborene und Gestorbene Wiesbaden:","author":"Statistisches Bundesamt","year":"2020"},{"key":"pone.0270490.ref018","volume-title":"Frauen mit Mehrlingsgeburten Wiesbaden:","author":"Statistisches Bundesamt","year":"2020"},{"key":"pone.0270490.ref019","volume-title":"Krankenhausentbindungen in Deutschland Wiesbaden:","author":"Statistisches Bundesamt","year":"2020"},{"issue":"4","key":"pone.0270490.ref020","doi-asserted-by":"crossref","first-page":"629","DOI":"10.1111\/j.1728-4457.2015.00088.x","article-title":"Twinning rates in developed countries: trends and explanations. Population and development review","volume":"41","author":"G Pison","year":"2015","journal-title":"Popul Dev Rev"},{"key":"pone.0270490.ref021","unstructured":"Bundesamt f\u00fcr Statistik. Births and deaths Neuchatel: Federal Statistical Office; 2021 [Available from: https:\/\/www.bfs.admin.ch\/bfs\/en\/home\/statistics\/population\/births-deaths.html."},{"key":"pone.0270490.ref022","unstructured":"Bundesamt f\u00fcr Statistik. Population Neuchatel Federal Statistical Office; 2021 [Cited 2020 September 30]. Available from: https:\/\/www.bfs.admin.ch\/bfs\/en\/home\/statistics\/population.html."},{"key":"pone.0270490.ref023","unstructured":"Euro-Peristat Project. European Perinatal Health Report. Core indicators of the health and care of pregnant women and babies in Europe in 2015. [Cited 2020 June 02]. Available from: https:\/\/www.europeristat.com\/images\/EPHR2015_web_hyperlinked_Euro-Peristat.pdf."},{"issue":"1","key":"pone.0270490.ref024","doi-asserted-by":"crossref","first-page":"284","DOI":"10.1186\/s12884-018-1912-0","article-title":"Short and long-term costs among women experiencing preterm labour or preterm birth: the German experience.","volume":"18","author":"S Pokras","year":"2018","journal-title":"BMC Pregnancy Childbirth"},{"key":"pone.0270490.ref025","doi-asserted-by":"crossref","first-page":"236","DOI":"10.1186\/1471-2393-13-236","article-title":"A structured review and exploration of the healthcare costs associated with stillbirth and a subsequent pregnancy in England and Wales.","volume":"13","author":"H Mistry","year":"2013","journal-title":"BMC Pregnancy Childbirth"},{"issue":"5","key":"pone.0270490.ref026","first-page":"505","article-title":"Cost of intensive care in a German hospital: cost-unit accounting based on the InEK matrix","volume":"57","author":"J Martin","year":"2008","journal-title":"Anaesthesist"},{"issue":"8","key":"pone.0270490.ref027","doi-asserted-by":"crossref","first-page":"1041","DOI":"10.1007\/s10198-016-0850-x","article-title":"Cost effects of preterm birth: a comparison of health care costs associated with early preterm, late preterm, and full-term birth in the first 3 years after birth.","volume":"18","author":"J Jacob","year":"2017","journal-title":"Eur J Health Econ"},{"key":"pone.0270490.ref028","doi-asserted-by":"crossref","DOI":"10.1093\/oso\/9780198529446.001.0001","volume-title":"Methods for the Economic Evaluation of Health Care Programmes.","author":"M Drummond","year":"2005"},{"issue":"2","key":"pone.0270490.ref029","doi-asserted-by":"crossref","first-page":"197.e1","DOI":"10.1016\/j.ajog.2018.10.092","article-title":"Two-stage screening for preterm preeclampsia at 11\u201313 weeks\u2019 gestation.","volume":"220","author":"A Wright","year":"2019","journal-title":"Am J Obstet Gynecol"},{"issue":"3","key":"pone.0270490.ref030","doi-asserted-by":"crossref","first-page":"537","DOI":"10.1097\/AOG.0000000000003413","article-title":"Strategies for Prescribing Aspirin to Prevent Preeclampsia: A Cost-Effectiveness Analysis.","volume":"134","author":"D Mallampati","year":"2019","journal-title":"Obstet Gynecol"},{"issue":"2","key":"pone.0270490.ref031","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1002\/uog.19076","article-title":"Cost-effectiveness of first-trimester screening with early preventative use of aspirin in women at high risk of early-onset pre-eclampsia.","volume":"53","author":"D Ortved","year":"2019","journal-title":"Ultrasound Obstet Gynecol"},{"key":"pone.0270490.ref032","doi-asserted-by":"crossref","first-page":"l1516","DOI":"10.1136\/bmj.l1516","article-title":"Pre-eclampsia and risk of later kidney disease: nationwide cohort study","volume":"365","author":"JH Kristensen","year":"2019","journal-title":"BMJ"},{"issue":"7627","key":"pone.0270490.ref033","doi-asserted-by":"crossref","first-page":"974","DOI":"10.1136\/bmj.39335.385301.BE","article-title":"Pre-eclampsia and risk of cardiovascular disease and cancer in later life: systematic review and meta-analysis","volume":"335","author":"L Bellamy","year":"2007","journal-title":"BMJ"},{"key":"pone.0270490.ref034","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1016\/j.earlhumdev.2016.09.007","article-title":"Preeclampsia; 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