11 research outputs found
Cost-effectiveness of acupuncture versus standard care for pelvic and low back pain in pregnancy: A randomized controlled trial
<div><p>Objective</p><p>To assess the cost-effectiveness of acupuncture for pelvic girdle and low back pain (PGLBP) during pregnancy.</p><p>Design</p><p>Pragmatic-open-label randomised controlled trial.</p><p>Setting</p><p>Five maternity hospitals</p><p>Population</p><p>Pregnant women with PGLBP</p><p>Method</p><p>1:1 randomization to standard care or standard care plus acupuncture (5 sessions by an acupuncturist midwife).</p><p>Main outcome measure</p><p>Efficacy: proportion of days with self-assessed pain by numerical rating scale (NRS) †4/10. Cost effectiveness (societal viewpoint, time horizon: pregnancy): incremental cost per days with NRS †4/10. Indirect non-healthcare costs included daily compensations for sick leave and productivity loss caused by absenteeism or presenteeism.</p><p>Results</p><p>96 women were allocated to acupuncture and 103 to standard care (total 199). The proportion of days with NRS †4/10 was greater in the acupuncture group than in the standard care group (61% vs 48%, p = 0.007). The mean Oswestry disability score was lower in the acupuncture group than with standard care alone (33 versus 38, Î = 5, 95% CI: 0.8 to 9, p = 0.02). Average total costs were higher in the control group (âŹ2947) than in the acupuncture group (âŹ2635, Î = ââŹ312, 95% CI: -966 to +325), resulting from the higher indirect costs of absenteeism and presenteeism. Acupuncture was a dominant strategy when both healthcare and non-healthcare costs were included. Costs for the health system (employer and out-of-pocket costs excluded) were slightly higher for acupuncture (âŹ1512 versus âŹ1452, Î = âŹ60, 95% CI: -272 to +470).</p><p>Conclusion</p><p>Acupuncture was a dominant strategy when accounting for employer costs. A 100% probability of cost-effectiveness was obtained for a willingness to pay of âŹ100 per days with pain NRS †4.</p></div
Factors associated with neonatal weight Z-score, sum of skinfolds, leptin and placenta weight in multivariate analysis.
<p>Data are presented with adjusted mean [standard error] for categorical variables or regression coefficient [standard error] for continuous variables.</p
Maternal and neonatal characteristics according to maternal BMI.
<p>Data are expressed as mean [SD] or N (%).</p
Multivariate analysis on skinfolds including HOMA-IR performed at 37 weeks in the model.
<p>The analysis was performed on data from 136 N and 124 Ob women. Data are presented with adjusted mean [standard error] for categorical variables or regression coefficient [standard error] for continuous variables. Only significant data are presented.</p
Adjusted neonatal cord leptin concentration according to maternal BMI and according to the sex of the neonate.
<p>Data are mean with 95% confidence limits.</p
Adjusted neonatal sum of skinfolds according to maternal BMI and according to the sex of the neonate.
<p>Data are mean with 95% confidence limits.</p
Flow chart of the study.
<p>Fetal losses in the group of women of normal weight were due to one termination of pregnancy for growth restriction and two fetal deaths; fetal losses in the group of women with obesity were due to one miscarriage, two terminations of pregnancy for neural tube defect and corpus callosum agenesis and one fetal death.</p
Mother-infant interaction at birth and 2 months postpartum.
<p>Mean composite scores are given from the Coding Interaction Procedure.</p
Maternal anxiety and depression over time.
<p>Mean scores are given for anxiety and depression (lines). Percentages indicate the number of participants with anxiety (or depression) scores above the scale clinical threshold (bars). T1â=âThird trimester during pregnancy, T2â=âBirth, T3â=â2 months after birth.</p
Diagram flow of the study.
<p>*Ultrasound soft markers included ventriculomegaly (Nâ=â8), increased nuchal translucency (Nâ=â16), Short OPN (Nâ=â4), echogenic bowel (Nâ=â19), echogenic intracardiac focus (Nâ=â2), mild pyelectasis (Nâ=â9), and short femur length (Nâ=â2).</p