Table 3.

Main findings (values are expressed in 2014 USD)

Study	Main findings
Screening and diagnosis approaches
Shmueli [27]	From a payer perspective, screening for pre-eclampsia is cost effective under various scenarios The incremental cost per pre-eclampsia case averted is $68,973 (prevalence 1.7 %) Early screening: $19,491 per QALY gained (prevalence 1.7 %) With a test cost of $115, the total cost until discharge with/without screening is equal; at a prevalence of 3%, screening is cheaper
Meads [26]	From a decision maker viewpoint, giving calcium supplementation to all pregnant women (‘no test/calcium all)’ without any initial testing is the most effective ‘test/treatment’ combination
Hadker [25]	The model estimated that the costs of a typical pregnancy are $2919 per patient when the new test is used, as compared with $4468 without the test (standard practice); this represents savings of $1549 per pregnant woman; the savings are attributed to the new test’s improved accuracy
Treatment approaches
Vijgen [29]	From a societal point of view, induction of delivery is cost effective compared with expectant monitoring in term pre-eclampsia; induction does not result in a higher rate of caesarean section, while fewer patients progress to severe disease
Simon [28]	From a hospital perspective, use of magnesium sulphate prevents more cases of eclampsia in low-GNI countries than in high-GNI countries High-GNI countries: $28,335 per case of eclampsia prevented Middle-GNI countries: $3,305 per case of eclampsia prevented Low-GNI countries: $609 per case of eclampsia prevented Also, treating only severe cases of pre-eclampsia substantially lowers the ICER, i.e. has a more favourable cost-to-effect ratio
Blackwell [30]	Universal prophylaxis using magnesium sulphate for all women with pre-eclampsia is cost effective compared with the strategy of treating only those with severe disease; ICER for universal compared with selected strategy: $13,356 per seizure prevented and $626,782 per death averted, which is considered cost effective assuming 1 death averted saves on average 30 life-years and given a threshold of $50,000 per life-year gained

GNI gross national income, ICER incremental cost-effectiveness ratio, QALY quality-adjusted life-year