Preferences of Pregnant Women and Family Members for Health States Arising From Anticoagulant Use in Pregnancy [17N]

INTRODUCTION: The aim of this study was to elicit preferences of pregnant women and their family member(s) involved in decision-making, for combined maternal and fetal health-states arising from the use of anticoagulants in pregnancy. METHODS: We conducted a cross-sectional study on pregnant women taking medications for chronic medical disorders and their family member(s). Participants–interviewed separately and together–were presented with seven vignettes representing combined maternal and fetal health-states related to anticoagulant use in pregnancy. They were asked to assign values on a visual analogue scale, by the standard gamble and time trade-off methods. Utility values (preferences) were presented on a scale of 0-100. RESULTS: Fifty-six pregnant women, 43 family members and 40 pairs completed the interviews. The median age was 32.9 years for pregnant women and 37.1 years for family members, and the median gestational age was 28.9 weeks. Regardless of the method used, values obtained from pregnant women were lower than those obtained from family members and combined interviews. There was a wide variation in utility values obtained from the three interviews and using the three methods. Values obtained from the combined interviews had the smallest confidence limits around point estimates. CONCLUSION: This is the first study to determine preferences from pregnant women and family members for combined maternal-fetal health-states. For studies involving pregnancy, utility values that represent the values of both individuals involved in decision-making should probably be used in decision-analysis studies. These findings need prospective validation in different patient populations and different clinical conditions.