Cost-effectiveness of an exercise program during pregnancy to prevent gestational diabetes: Results of an economic evaluation alongside a randomised controlled trial Full Text
BMC Pregnancy and Childbirth, 07/05/2012
Oostdam N et al. – The twice–weekly exercise program for pregnant women at risk for GDM evaluated in the present study was not cost–effective compared to standard care. Based on these results, implementation of this exercise program for the prevention of GDM cannot be recommended.Methods
- A randomised controlled trial (RCT) and simultaneous economic evaluation of the FitFor2 program were conducted.
- Pregnant women at risk for GDM were randomised to an exercise program to prevent high maternal blood glucose (n = 62) or to standard care (n = 59).
- The exercise program consisted of two sessions of aerobic and strengthening exercises per week.
- Clinical outcome measures were maternal fasting blood glucose levels, insulin sensitivity and infant birth weight.
- Quality of life was measured using the EuroQol 5–D and quality–adjusted life–years (QALYs) were calculated. Resource utilization and sick leave data were collected by questionnaires.
- Data were analysed according to the intention–to–treat principle. Missing data were imputed using multiple imputations.
- Bootstrapping techniques estimated the uncertainty surrounding the cost differences and incremental cost–effectiveness ratios.
- There were no statistically significant differences in any outcome measure.
- During pregnancy, total health care costs and costs of productivity losses were statistically non significant (mean difference E1308; 95%CI E–229 – E3204).
- The cost–effectiveness analyses showed that the exercise program was not cost–effective in comparison to the control group for blood glucose levels, insulin sensitivity, infant birth weight or QALYs.