拒绝堕胎对慢性肾脏疾病患者的影响：成本效益分析。

IF 2.8 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Contraception Pub Date : 2025-03-10 DOI:10.1016/j.contraception.2025.110863

Sydney McCarthy, Julia Tasset, Olivia Curl, Sarah Dzubay, Aaron B. Caughey

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引用次数: 0

摘要

目的：目前的研究重点是堕胎对怀孕、患有慢性肾脏疾病（CKD）并希望堕胎的人的影响。从怀孕患者的角度出发，我们将研究为这一人群提供或拒绝在州内堕胎的相关结果和成本。研究设计：建立了一个决策分析模型，以比较在州内提供堕胎与在全州范围内完全禁止堕胎相关的结果和成本。该模型包括妊娠CKD的结局，并考虑疾病的进展。该模型还考虑了前往另一个州堕胎的可能性和相关费用。结果：在31243名CKD孕妇中，流产导致1350例先兆子痫减少，2703例早产减少，4837例CKD阶段进展减少，841例终末期肾脏疾病需要透析，每年死亡人数减少9人。与有堕胎通道的州相比，缺少州内堕胎通道与533,874,448美元的成本增加和6,873个qaly减少有关。结论：由于直接降低子痫前期、早产、死亡率和肾脏疾病的进展，为患有慢性肾脏疾病的孕妇提供州内流产是一种具有成本效益的策略。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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The impact of denying abortion access to patients with chronic kidney disease: A cost-effectiveness analysis

Objectives

The current study focuses on how abortion access affects people who are pregnant, have chronic kidney disease (CKD), and desire an abortion. From the perspective of the pregnant patient, we will examine the outcomes and costs associated with providing or refusing in-state access to abortion for this population.

Study design

A decision-analytic model was built to compare the outcomes and costs associated with providing abortions in-state compared to those associated with a complete statewide abortion ban. The model includes outcomes of pregnancy with CKD and considers the progression of disease. The model also considers the likelihood and costs associated with traveling to another state for an abortion.

Results

In a cohort of 31,243 pregnant people with CKD desiring an abortion, providing abortions resulted in 1350 fewer cases of preeclampsia, 2703 fewer preterm births, 4837 fewer cases of CKD stage progression, 841 fewer cases of end-stage renal disease requiring dialysis, and nine fewer deaths per year. An absence of in-state abortion access was associated with an increased cost of $533,874,448 and a decrease of 6873 quality adjusted life years (QALYs) compared to states with abortion access.

Conclusion

Providing in-state abortion access to pregnant people with chronic kidney disease is a cost-effective strategy, due to the direct decrease in preeclampsia, preterm birth, mortality, and progression of kidney disease.

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来源期刊

Contraception 医学-妇产科学

CiteScore

4.70

自引率

17.20%

发文量

211

审稿时长

69 days

期刊介绍： Contraception has an open access mirror journal Contraception: X, sharing the same aims and scope, editorial team, submission system and rigorous peer review. The journal Contraception wishes to advance reproductive health through the rapid publication of the best and most interesting new scholarship regarding contraception and related fields such as abortion. The journal welcomes manuscripts from investigators working in the laboratory, clinical and social sciences, as well as public health and health professions education.