Publication:

Cost-effectiveness analysis of serological prenatal screening for pregnant women in King Abdulaziz University Hospital: a single-center retrospective study

Background Congenital primary infections with Toxoplasma gondii, cytomegalovirus (CMV), Epstein–Bar virus (EBV), rubella, and hepatitis B virus (HBV) are viral infections transmitted transplacentally through the blood to the fetus and can be life-threatening. Therefore, we aimed to determine the prevalence of these infections and assess the cost-effectiveness of blood tests among pregnant women with positive serologies.

Methods This retrospective review was conducted among pregnant women with positive prenatal screening serology test results between January 2013 to July 2018. A p-value of <0.05 was used to calculate statistical significance.

Results Overall, 9095 pregnant women delivered in the last 5 years. Of these, 97 had positive prenatal screening serology and were enrolled in our study. Of 97, 61 (62.9%) were Saudis and 36 (37.1%) non-Saudis. The prevalence rates of rubella, CMV, EBV, and HBV were 78.35%, 59.79%, 14.43%, and 5.15%, respectively. Additionally, 44 of 97 women developed undesired antepartum outcomes, whereas 47 had adverse neonatal outcomes. CMV, HBV, and rubella were significantly associated with adverse pregnancy outcomes (P<0.005). During the study period, USD 1460228.27 was spent to screen 9095 pregnant women and USD 15573.68 to diagnose 97 pregnant women with positive serology.

Conclusions Because infections with toxoplasma, CMV, EBV, rubella, and HBV can cause serious risk to the mother and fetus during pregnancy. Thus, setting new hospital policies regarding early screening for high-risk pregnancies and early detection of these infections during prenatal visits are inevitable to avoid undesired outcomes.