Document Detail

Preconception care: preliminary estimates of costs and effects of smoking cessation and folic acid supplementation.
MedLine Citation:
PMID:  15214705     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To assess costs and effectiveness of preconception counseling for all women planning pregnancy in The Netherlands with regard to folic acid supplementation and smoking cessation counseling. STUDY DESIGN: Costs and effects were estimated based on 200,000 women approached yearly and uptake rates of 50% and 75%. Effectiveness and potential savings were based on hospital costs of neural tube defects, low birth weight, very low birth weight and perinatal death attributable to maternal smoking. RESULTS: Total costs were estimated at dollar 5.1 million and dollar 7.2 million at uptake rates of 50% and 75%, respectively. If 50% of women would seek preconception counseling, 22 neural tube defects, 98 low-birth-weight infants, 10 very-low-birth-weight infants and 7 perinatal deaths could be avoided. At 75% uptake, 33 neural tube defects, 146 low- and 15 very-low-birth-weight infants, and 11 perinatal deaths could be avoided. CONCLUSION: Net costs of preconception counseling amount to dollar 3.7 million and dollar 5.0 million when considering cases prevented and subsequent potential savings in costs of neural tube defects and smoking-related morbidity only. However, in light of many other preventable adverse outcomes and the potential of preconception counseling to prevent significant lifetime costs for affected children, the net costs may ultimately result in a favorable cost-savings balance. Moreover, the importance of a healthy child cannot be expressed in terms of costs and savings alone.
Sabina de Weerd; Johan J Polder; Titia E Cohen-Overbeek; Luc J I Zimmermann; Eric A P Steegers
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of reproductive medicine     Volume:  49     ISSN:  0024-7758     ISO Abbreviation:  J Reprod Med     Publication Date:  2004 May 
Date Detail:
Created Date:  2004-06-24     Completed Date:  2004-08-31     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0173343     Medline TA:  J Reprod Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  338-44     Citation Subset:  IM    
Department of Obstetrics and Gynecology, Erasmus Medical Center Rotterdam, The Netherlands.
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MeSH Terms
Cost Savings
Cost-Benefit Analysis
Dietary Supplements*
Folic Acid / therapeutic use*
Hospital Costs / statistics & numerical data
Infant Mortality*
Infant, Newborn
Infant, Very Low Birth Weight*
Neural Tube Defects / economics,  prevention & control
Preconception Care / economics*
Pregnancy Outcome*
Smoking Cessation / economics*
Reg. No./Substance:
59-30-3/Folic Acid

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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