title: Cost-effectiveness analysis of cardiovascular risk factor screening in women who experienced hypertensive pregnancy disorders at term.
abstract: OBJECTIVE
  To assess the cost-effectiveness of post-partum screening on cardiovascular risk factors and subsequent treatment in women with a history of gestational hypertension or pre-eclampsia at term.
  
  
  METHODS
  Two separate Markov models evaluated the cost-effectiveness analysis of hypertension (HT) screening and screening on metabolic syndrome (MetS), respectively, as compared to current practice in women with a history of term hypertensive pregnancy disorders. Analyses were performed from the Dutch health care perspective, using a lifetime horizon. One-way sensitivity analyses and Monte Carlo simulation evaluated the robustness of the results.
  
  
  RESULTS
  Both screening on HT and MetS in women with a history of gestational hypertension or pre-eclampsia resulted in increase in life expectancy (HT screening 0.23year (95% CI -0.06 to 0.54); MetS screening 0.14years (95% CI -0.16 to 0.45)). The gain in QALYs was limited, with HT screening and MetS screening generating 0.04 QALYs (95% CI -0.12 to 0.20) and 0.03 QALYs (95% CI -0.14 to 0.19), resulting in costs to gain one QALY of €4228 and €28,148, respectively. Analyses for uncertainty showed a chance of 74% and 75%, respectively, that post-partum screening is cost-effective at a threshold of €60,000/QALY.
  
  
  CONCLUSIONS
  According to the available knowledge post-partum screening on cardiovascular risk factors and subsequent treatment in women with a history of gestational hypertension or pre-eclampsia at term is likely to be cost-effective.
authors.affiliation: Department of Obstetrics and Gynecology, Academic Medical Center, 1105 DE Amsterdam, The Netherlands. Electronic address: g.j.vanbaaren@amc.uva.nl.
authors.forename: Gert-Jan
authors.initials: GJ
authors.lastname: van Baaren
authors.affiliation: Department of Obstetrics and Gynecology, Medical Center Haaglanden, Lijnbaan 32, 2512 VA The Hague, The Netherlands. Electronic address: herwie@mchaaglanden.nl.
authors.forename: Wietske
authors.initials: W
authors.lastname: Hermes
authors.affiliation: Department of Obstetrics and Gynecology, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands. Electronic address: a.franx-2@umcutrecht.nl.
authors.forename: Arie
authors.initials: A
authors.lastname: Franx
authors.affiliation: Department of Obstetrics and Gynecology, The Onze Lieve Vrouwe Gasthuis (OLVG) Hospital, Oosterpark 9, 1091 AC Amsterdam, The Netherlands. Electronic address: m.g.vanpampus@olvg.nl.
authors.forename: Maria G
authors.initials: MG
authors.lastname: van Pampus
authors.affiliation: Department of Obstetrics, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands. Electronic address: k.w.m.bloemenkamp@lumc.nl.
authors.forename: Kitty W M
authors.initials: KW
authors.lastname: Bloemenkamp
authors.affiliation: Department of Obstetrics and Gynecology, Academic Medical Center, 1105 DE Amsterdam, The Netherlands. Electronic address: j.a.vanderpost@amc.uva.nl.
authors.forename: Joris A
authors.initials: JA
authors.lastname: van der Post
authors.affiliation: Department of Obstetrics and Gynecology, Máxima Medical Center, De Run 4600, 5504 DB Veldhoven, The Netherlands. Electronic address: m.porath@mmc.nl.
authors.forename: Martina
authors.initials: M
authors.lastname: Porath
authors.affiliation: Department of Clinical Chemistry, Medical Center Haaglanden, Lijnbaan 32, 2512 VA The Hague, The Netherlands. Electronic address: g.ponjee@mchaaglanden.nl.
authors.forename: Gabrielle A E
authors.initials: GA
authors.lastname: Ponjee
authors.affiliation: Section of Vascular Medicine, Department of Endocrinology and Internal Medicine, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands. Electronic address: j.t.tamsma@lumc.nl.
authors.forename: Jouke T
authors.initials: JT
authors.lastname: Tamsma
authors.affiliation: Department of Obstetrics and Gynecology, The Robinson Institute, School of Paediatrics and Reproductive Health, University of Adelaide, Australia. Electronic address: ben.mol@adelaide.edu.au.
authors.forename: Ben Willem J
authors.initials: BW
authors.lastname: Mol
authors.affiliation: Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Academic Medical Center, 1105 DE Amsterdam, The Netherlands. Electronic address: b.c.opmeer@amc.uva.nl.
authors.forename: Brent C
authors.initials: BC
authors.lastname: Opmeer
authors.affiliation: Department of Obstetrics and Gynaecology, VU University Medical Center, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands. Electronic address: cdegroot@me.com.
authors.forename: Christianne J M
authors.initials: CJ
authors.lastname: de Groot
keywords: Cardiovascular risk; Cost-effectiveness; Gestational hypertension; Pre-eclampsia; Pregnancy