Clinical and economic outcomes of preterm labor management: inpatient vs outpatient.
OBJECTIVE
To compare pregnancy and economic outcomes in women receiving inpatient vs outpatient tocolysis with continuous subcutaneous terbutaline (SQT).


METHODS
Identified within a database were women prescribed SQT at 24.0 to 33.9 weeks' gestation following stabilization of an acute episode of preterm labor. Women with cervical dilatation >3 cm, and/or maternal or fetal instability were excluded. Those with prolonged inpatient care were matched 1:1 to those discharged with outpatient follow-up by cervical dilatation, gestational age, and fetal number yielding 90 matched pairs (180 women).


RESULTS
Inpatients had an earlier gestational age at delivery (34.1+/-2.9 vs 35.8+/-1.9 weeks, p<0.001), higher preterm birth rate (86.7% vs 74.4%, p=0.043) and higher overall costs (56,089 dollars+/-47,944 dollars vs 25,540 dollars+/-25,847 dollars, p<0.001) than outpatients.


CONCLUSIONS
Outpatient management resulted in improved pregnancy outcomes at a cost less than that of inpatient management in this analysis of women treated with SQT.
Ambrose
Steven
S
Christ Hospital & Medical Center, Oak Lawn, IL, USA.
Rhea
Debbie J
DJ
Istwan
Niki B
NB
Collins
Ann
A
Stanziano
Gary
G
D000328:Adult; D000553:Ambulatory Care / Q000191:economics; D004334:Drug Administration Schedule; D005260:Female; D005845:Georgia / Q000453:epidemiology; D005865:Gestational Age; D017721:Hospital Costs; D006760:Hospitalization / Q000191:economics; D006801:Humans; D007231:Infant, Newborn; D007279:Injections, Subcutaneous; D007752:Obstetric Labor, Premature / Q000188:drug therapy* / Q000191:economics*; D017063:Outcome Assessment, Health Care; D018743:Perinatal Care / Q000191:economics* / Q000379:methods; D011247:Pregnancy; D013726:Terbutaline / Q000008:administration & dosage / Q000627:therapeutic use*; D015149:Tocolytic Agents / Q000008:administration & dosage / Q000627:therapeutic use*
D015149:Tocolytic Agents; D013726:Terbutaline