Thrombosis research · 2026
Preferences of pregnant individuals and family members for maternal-fetal health states related to anticoagulant use in pregnancy.
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D'Souza Rohan, Tomlinson George, Bonasia Kyra, Wuebbolt Danielle, Nguyen Vanessa, Peterson Wynn, Khowaja Bakhtawar M Hanif, Shah Prakesh S, Krahn Murray, Murphy Kellie E, Sander Beate
Аннотация
BACKGROUND: A considerable number of pregnant individuals are prescribed anticoagulants in pregnancy.
OBJECTIVE(S): To obtain and compare preference values for combined maternal-fetal health states arising from anticoagulant use in pregnancy from pregnant individuals and their family members.
STUDY DESIGN: We conducted a cross-sectional study at a tertiary referral centre in Toronto, Canada from July to October 2015. A diverse group of pregnant individuals receiving anticoagulants and family members involved in medical decision-making were interviewed individually and together. Participants assigned values to seven maternal-fetal health states using the visual analogue scale (VAS), time trade-off (TTO), and standard gamble (SG) instruments on a 0-100 scale, where 0 represented maternal-fetal death and 100 perfect maternal-fetal health.
RESULTS: We recruited 57 pregnant individuals and 43 family members, of which 40 pairs completed all interviews. There were significant differences between preferences based on instruments, scenarios, and respondents. Across interviews and instruments, participants assigned lowest preference values to health states involving major fetal malformations and fetal death. Preferences obtained through shared interviews showed a significant shift away from those obtained from pregnant individuals and towards those of family members. Participants better understood and preferred the VAS and SG over the TTO.
CONCLUSION(S): This study in addition to generating patient-preference values to inform decision analysis and economic evaluation studies, also highlights the importance families attribute to fetal complications while making clinical decisions during pregnancy. The role of shared interviews and the use of SG in eliciting preferences for pregnancy health states needs further exploration.
OBJECTIVE(S): To obtain and compare preference values for combined maternal-fetal health states arising from anticoagulant use in pregnancy from pregnant individuals and their family members.
STUDY DESIGN: We conducted a cross-sectional study at a tertiary referral centre in Toronto, Canada from July to October 2015. A diverse group of pregnant individuals receiving anticoagulants and family members involved in medical decision-making were interviewed individually and together. Participants assigned values to seven maternal-fetal health states using the visual analogue scale (VAS), time trade-off (TTO), and standard gamble (SG) instruments on a 0-100 scale, where 0 represented maternal-fetal death and 100 perfect maternal-fetal health.
RESULTS: We recruited 57 pregnant individuals and 43 family members, of which 40 pairs completed all interviews. There were significant differences between preferences based on instruments, scenarios, and respondents. Across interviews and instruments, participants assigned lowest preference values to health states involving major fetal malformations and fetal death. Preferences obtained through shared interviews showed a significant shift away from those obtained from pregnant individuals and towards those of family members. Participants better understood and preferred the VAS and SG over the TTO.
CONCLUSION(S): This study in addition to generating patient-preference values to inform decision analysis and economic evaluation studies, also highlights the importance families attribute to fetal complications while making clinical decisions during pregnancy. The role of shared interviews and the use of SG in eliciting preferences for pregnancy health states needs further exploration.