Pregnancy and economic outcomes in patients treated for recurrent preterm labor.
OBJECTIVE
To compare clinical and cost-effectiveness of treating recurrent preterm labor (RPTL) with oral nifedipine versus continuous subcutaneous terbutaline infusion (SQT).


METHODS
Women with singleton gestations prescribed nifedipine for tocolysis following first diagnosis of preterm labor were identified. Women hospitalized with RPTL at <34 weeks were matched by gestational age (GA) after resuming nifedipine (NIF group) with women prescribed SQT (SQT group) after stabilization. Healthcare utilization costs were modeled and compared.


RESULTS
This study analyzed 142 matched pairs. GA at RPTL (matched variable) was 30.4+/-2.6 weeks. GA at delivery was earlier in the NIF group versus the SQT group (35.7+/-3.1 weeks versus 36.6+/-2.1 weeks, p=0.004). Overall, infants from the NIF group had lower birth weights and higher nursery days than infants from the SQT group. Healthcare utilization costs were greater in the NIF group versus the SQT group (37,040+/-47,518 US dollars versus 26,546+/-25,386 US dollars, p=0.014).


CONCLUSIONS
Treating RPTL with SQT versus oral nifedipine resulted in a later GA at delivery, improved neonatal outcome, and increased cost-effectiveness.
Department of Obstetrics and Gynecology, Creighton University Medical Center, Omaha, NE 68131, USA.
Alfred
A
Fleming
Robert
R
Bonebrake
Niki
N
Istwan
Debbie
D
Rhea
Suzanne
S
Coleman
Gary
G
Stanziano
D000284:Administration, Oral; D000328:Adult; D016022:Case-Control Studies; D003362:Cost-Benefit Analysis; D003365:Costs and Cost Analysis; D005260:Female; D006801:Humans; D015918:Infusion Pumps, Implantable; D009543:Nifedipine / Q000008:administration & dosage / Q000627:therapeutic use*; D007752:Obstetric Labor, Premature / Q000191:economics* / Q000517:prevention & control*; D011247:Pregnancy; D011256:Pregnancy Outcome; D012008:Recurrence; D012189:Retrospective Studies; D013726:Terbutaline / Q000008:administration & dosage / Q000627:therapeutic use*; D015145:Tocolysis / Q000191:economics* / Q000379:methods; D015149:Tocolytic Agents / Q000008:administration & dosage / Q000627:therapeutic use*
D015149:Tocolytic Agents; D009543:Nifedipine; D013726:Terbutaline