Document Detail

Routine prenatal screening for HIV in a low-prevalence setting.
MedLine Citation:
PMID:  9834719     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The objectives of this study were to assess the effect of British Columbia's June 1994 guidelines for prenatal HIV screening on the rate of maternal-fetal HIV transmission and to estimate the cost-effectiveness of such screening. METHODS: The authors conducted a retrospective review of pregnancy and delivery statistics, HIV screening practices, laboratory testing volume, prenatal and labour management decisions of HIV-positive women, maternal-fetal transmission rates and associated costs. RESULTS: Over 1995 and 1996, 135,681 women were pregnant and 92,645 carried to term. The rate of HIV testing increased from 55% to 76% of pregnancies on chart review at one hospital between November 1995 and November 1996. On the basis of seroprevalence studies, an estimated 50.2 pregnancies and 34.3 (95% confidence interval 17.6 to 51.0) live births to HIV-positive women were expected. Of 42 identified mother-infant pairs with an estimated date of delivery during 1995 or 1996, 25 were known only through screening. Of these 25 cases, there were 10 terminations, 1 spontaneous abortion and 14 cases in which the woman elected to carry the pregnancy to term with antiretroviral therapy. There was one stillbirth. One instance of maternal-fetal HIV transmission occurred among the 13 live births. The net savings attributable to prevented infections among babies carried to term were $165,586, with a saving per prevented case of $75,266. INTERPRETATION: A routine offer of pregnancy screening for HIV in a low-prevalence setting reduces the rate of maternal-fetal HIV transmission and may rival other widely accepted health care expenditures in terms of cost-effectiveness.
D M Patrick; D M Money; J Forbes; S R Dobson; M L Rekart; D A Cook; P J Middleton; D R Burdge
Related Documents :
24253049 - Long-term disruption of maternal glucose homeostasis induced by prenatal glucocorticoid...
6812499 - Microbial models of mammalian metabolism: o-dealkylation of para-alkoxybiphenyls.
14558029 - First-trimester screening for down syndrome in france combining fetal nuchal translucen...
15912479 - Screening for down syndrome based on maternal age or fetal nuchal translucency: a rando...
23318499 - Serum levels of growth arrest specific protein 6 are increased in preeclampsia.
18754289 - Silicone gel mammary prostheses: immune pathologies and breastfeeding.
2294719 - Clinical experience with fetal echocardiography.
12078469 - Acute fatty liver of pregnancy: a case report.
24382949 - Early pregnancy diagnosis in bovines: current status and future directions.
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne     Volume:  159     ISSN:  0820-3946     ISO Abbreviation:  CMAJ     Publication Date:  1998 Oct 
Date Detail:
Created Date:  1998-12-11     Completed Date:  1998-12-11     Revised Date:  2009-11-18    
Medline Journal Info:
Nlm Unique ID:  9711805     Medline TA:  CMAJ     Country:  CANADA    
Other Details:
Languages:  eng     Pagination:  942-7     Citation Subset:  AIM; IM; N; X    
British Columbia Centre for Disease Control Society, Vancouver.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
British Columbia / epidemiology
Cost-Benefit Analysis
HIV Infections / diagnosis*,  epidemiology,  ethnology,  prevention & control*,  transmission
Infectious Disease Transmission, Vertical / prevention & control*
Mass Screening* / economics,  statistics & numerical data
Pregnancy Complications, Infectious / diagnosis*,  epidemiology,  ethnology,  virology
Prenatal Care* / economics,  statistics & numerical data
Retrospective Studies
Risk Factors
Comment In:
CMAJ. 1999 May 4;160(9):1286-7   [PMID:  10333827 ]

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

Previous Document:  Cost-effectiveness of low-molecular-weight heparin and unfractionated heparin in treatment of deep v...
Next Document:  Bioethics for clinicians: 17. Conflict of interest in research, education and patient care.