Does availability of fetal firbonectin testing in the management of threatened preterm labour affect the utilization of hospital resources?
OBJECTIVE
To examine how the availability of fetal fibronectin testing affects the utilization of hospital resources.


METHODS
A comparison of the rates, duration, and costs of hospitalization for a prospective cohort of women who presented with preterm labour after fetal fibronectin (Ffn) testing became available, and a historical baseline cohort who presented with preterm labour before fetal fibronectin testing was available. The study included singleton pregnancies presenting between 24 and 34 weeks' gestation with signs and symptoms of preterm labour. The women in each study cohort presented during a designated 20-week period.


RESULTS
We examined the records of 116 subjects with comparable gestational age distributions in each 20-week period. During the study period when Ffn testing was available, 51 tests were performed. Four tests were invalid, and 12 subjects who were tested did not meeting the inclusion criteria. Admissions for preterm labour in the study period were significantly less than in the baseline cohort (12.1% vs. 24.1%, P = 0.03), with no difference in preterm births (8.6% vs. 7.8%). The mean length of stay per patient with preterm labour declined from 5.2 days to 0.6 days (P < 0.0001), and the mean cost per patient with preterm labour declined from $3666 to $581 (P < 0.0001). In the 20-week study period, there was a reduction in total length of hospital stay from 145 to 28 days, with an overall reduction in total cost from $102 660 to $26 169.


CONCLUSIONS
The availability of Ffn testing was associated with a reduction in hospital admissions, length of hospital stay, and overall hospital costs in the management of threatened preterm labour.
Abenhaim
Haim A
HA
Department of Obstetrics and Gynecology, Royal Victoria Hospital, McGill University, Montreal, QC.
Morin
Lucie
L
Benjamin
Alice
A
D000328:Adult; D015331:Cohort Studies; D003362:Cost-Benefit Analysis; D005260:Female; D005353:Fibronectins / Q000032:analysis*; D006023:Glycoproteins / Q000032:analysis*; D006760:Hospitalization / Q000191:economics*; D006801:Humans; D007902:Length of Stay; D007752:Obstetric Labor, Premature / Q000191:economics* / Q000517:prevention & control*; D011247:Pregnancy; D011446:Prospective Studies
C403421:FFN protein, human; D005353:Fibronectins; D006023:Glycoproteins