title: Clinical and cost-effectiveness of continuous subcutaneous terbutaline versus oral tocolytics for treatment of recurrent preterm labor in twin gestations.
abstract: OBJECTIVE
  To compare the clinical and cost-effectiveness of treating recurrent preterm labor with continuous subcutaneous terbutaline versus oral tocolytics in twin gestations.
  
  
  METHODS
  In a retrospective, matched-cohort design, twin pregnancies treated as outpatients with continuous subcutaneous terbutaline were identified from a perinatal database, then matched 1:1 by gestational age at recurrent preterm labor to those receiving oral tocolytics. There were 353 patients per treatment group. A cost model was used to compare antepartum hospital, nursery, and outpatient charges.
  
  
  RESULTS
  Infants of the subcutaneous terbutaline group had greater gestational age at delivery, higher birth weights, and less frequent neonatal intensive care unit admission. Charges for antepartum hospitalization and nursery were significantly less in the subcutaneous terbutaline group, while charges for outpatient services were less for the oral group. Mean total estimated charges were US$17,109 less for those receiving subcutaneous terbutaline.
  
  
  CONCLUSIONS
  Improved clinical outcomes and decreased nursery utilization suggest cost-effectiveness of outpatient continuous subcutaneous terbutaline versus oral tocolytics for the treatment of recurrent preterm labor.
authors.affiliation: California Pacific Medical Center, 3838 California Street, San Francisco, CA 94118, USA.
authors.forename: F
authors.initials: F
authors.lastname: Lam
authors.forename: N K
authors.initials: NK
authors.lastname: Bergauer
authors.forename: D
authors.initials: D
authors.lastname: Jacques
authors.forename: S K
authors.initials: SK
authors.lastname: Coleman
authors.forename: G J
authors.initials: GJ
authors.lastname: Stanziano
mesh_terms: D000284:Administration, Oral; D015331:Cohort Studies; D003362:Cost-Benefit Analysis / Q000191:economics; D005260:Female; D018718:Home Infusion Therapy / Q000191:economics*; D017722:Hospital Charges; D006801:Humans; D007231:Infant, Newborn; D007263:Infusions, Parenteral / Q000191:economics; D007752:Obstetric Labor, Premature / Q000188:drug therapy* / Q000191:economics*; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000191:economics; D012008:Recurrence; D012189:Retrospective Studies; D013726:Terbutaline / Q000008:administration & dosage* / Q000191:economics* / Q000627:therapeutic use; D015149:Tocolytic Agents / Q000008:administration & dosage* / Q000191:economics* / Q000627:therapeutic use; D014427:Twins
chemical_list: D015149:Tocolytic Agents; D013726:Terbutaline