Specialized care for twin gestations: improving newborn outcomes and reducing costs.
OBJECTIVE
To compare newborn outcomes and costs of hospital stays for twins born to mothers receiving care in a specialized twin clinic with a research-based care protocol and one consistent caregiver versus twins whose mothers received standard prenatal care.


METHODS
A retrospective, historical cohort study conducted in a high-risk obstetric clinic in central Texas.


METHODS
Thirty women pregnant with twins received specialized care. The comparison group consisted of 41 women pregnant with twins who received standard care.


METHODS
An advanced practice nurse provided prenatal care, which included weekly clinic visits, home visits, and 24-hour availability for phone support.


METHODS
Gestational age at birth, birth weight, length of stay in the neonatal intensive-care unit (NICU), and hospital charges for the newborns.


RESULTS
No newborns of less than 30 weeks gestation were born to women in the specialized care group, the mean birth weight was 249 g (SD +/- 77) higher, days in the NICU were reduced from a mean of 17 to 7, and hospital charges were $30,000 less per infant.


CONCLUSIONS
Newborn outcomes were improved and length of stay and hospital charges were significantly reduced for newborns whose mothers had received care in the specialized twin clinic.
University of Texas Health Science Center, San Antonio, USA. Ruizr@uthscsa.edu
R J
RJ
Ruiz
C E
CE
Brown
M T
MT
Peters
A B
AB
Johnston
D000328:Adult; D001724:Birth Weight; D003363:Cost Control; D005260:Female; D005865:Gestational Age; D017722:Hospital Charges / Q000706:statistics & numerical data; D006801:Humans; D007231:Infant, Newborn; D007902:Length of Stay / Q000191:economics; D016389:Maternal-Child Nursing / Q000458:organization & administration*; D009722:Nurse Practitioners / Q000458:organization & administration*; D015403:Nursing Evaluation Research; D017063:Outcome Assessment, Health Care; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology; D018566:Pregnancy, High-Risk; D011295:Prenatal Care / Q000458:organization & administration*; D012189:Retrospective Studies; D013781:Texas / Q000453:epidemiology; D014427:Twins