[Parvovirus B-19 infections in pregnant women in day care facilities: health economic analysis of prohibition to employ seronegative women].
German protective legislation during pregnancy and maternity prohibit employing pregnant women if occupational activities endanger the health of either the mother-to-be or the fetus. This applies for parvovirus B19 seronegative women caring for children <6 years. Here we present a cost-effectiveness analysis from the view of the society for the prohibition to employ B19-seronegative women in day care. Prohibition of employment starting at the first day of pregnancy may prevent 1.4 cases of fetal death (mortality) and 1.7 cases of hydrops fetalis (morbidity) per year resulting in costs of 30 million <euro> (22 million <euro>/live birth). The incidence of B19 infection, the elevated occupational risk and the fetal death rate were varied in sensitivity analyses. This resulted in 0.2-3.1 fetal deaths prevented per year and costs between 10 million <euro> and 150 million <euro> per live birth. Indeed, the protective effect is assumed to be even lower since 30% of fetal deaths occur after infection during the first 8 weeks of pregnancy. During that time prohibition of employment is often unrealistic since the majority of women are not aware of pregnancy. In conclusion a small number of fetal lives can be saved by prohibiting employment in contrast to the extremely high costs. The regulations for maternal protection should be revised.
Gärtner
B
B
Universitätsklinikum Homburg/Saar, BRD. vibgal@uniklinikum-saarland.de
Enders
M
M
Luft-Duchow
C
C
Bocharov
G
G
Modorow
S
S
D000328:Adult; D003362:Cost-Benefit Analysis; D003631:Day Care, Medical / Q000191:economics* / Q000706:statistics & numerical data; D004651:Employment / Q000191:economics* / Q000706:statistics & numerical data; D005260:Female; D005858:Germany / Q000453:epidemiology; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006801:Humans; D010322:Parvoviridae Infections / Q000191:economics* / Q000453:epidemiology / Q000276:immunology; D016732:Parvovirus B19, Human; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000191:economics* / Q000453:epidemiology / Q000276:immunology; D015995:Prevalence