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Early onset sepsis calculator-based management of newborns exposed to maternal intrapartum fever: a cost benefit analysis

Journal of Perinatology volume 39, pages 571–580 (2019)Cite this article

Subjects

Abstract

Objective

To determine potential net monetary benefit of an early onset sepsis calculator-based approach for management of neonates exposed to maternal intrapartum fever, compared to existing guidelines.

Study design

We performed a cost-benefit analysis comparing two management approaches for newborns >34 weeks gestational age exposed to maternal intrapartum fever. Probabilities of sepsis and meningitis, consequences of infection and antibiotic use, direct medical costs, and indirect costs for long-term disability and mortality were considered.

Results

A calculator-based approach resulted in a net monetary benefit of $3998 per infant with a 60% likelihood of net benefit in probabilistic sensitivity analysis. Our model predicted a 67% decrease in antibiotic use in the calculator arm. The absolute difference for all adverse clinical outcomes between approaches was ≤0.6%.

Conclusions

Compared to existing guidelines, a calculator-based approach for newborns exposed to maternal intrapartum fever yields a robust net monetary benefit, largely by preventing unnecessary antibiotic treatment.

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Author information

Authors and Affiliations

  1. University of Southern California Leonard D. Schaeffer Center for Health Policy & Economics, Los Angeles, CA, USA

    Cynthia L. Gong & Joel W. Hay

  2. Children’s Hospital of Los Angeles, Fetal & Neonatal Institute, Los Angeles, CA, USA

    Cynthia L. Gong

  3. Division of Pediatric Infectious Diseases, Harbor-UCLA Medical Center, Los Angeles, CA, USA

    Shom Dasgupta-Tsinikas, Kenneth M. Zangwill & Michael Bolaris

  4. Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Los Angeles, CA, USA

    Kenneth M. Zangwill & Michael Bolaris

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Correspondence to Cynthia L. Gong.

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Gong, C.L., Dasgupta-Tsinikas, S., Zangwill, K.M. et al. Early onset sepsis calculator-based management of newborns exposed to maternal intrapartum fever: a cost benefit analysis. J Perinatol 39, 571–580 (2019). https://doi.org/10.1038/s41372-019-0316-y

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