The association of elective cessation of tocolysis and preterm birth in singleton gestations.
We evaluated outcomes following tocolysis discontinuation in singleton pregnancies between 33.0 and 36.9 weeks' gestation. We performed a retrospective analysis of singleton pregnancies prescribed continuous subcutaneous terbutaline tocolysis. Patients without indicated preterm delivery discontinuing treatment between 33.0 and 36.9 weeks were evaluated ( N = 4253). Data were grouped by week at treatment discontinuation. Outcomes were compared for each week. Approximately 55% (2316/4253) delivered preterm (< 37 weeks). After treatment discontinuation, 58.1% (2472/4253) of patients delivered within 7 days and 41.2% (1752/4253) within 3 days. Median number of days from discontinuation to delivery was 5 (range, 0 to 65). Incidence of low birth weight (< or = 2500 g), neonatal intensive care unit admissions, days in nursery, and estimated charges decreased with each additional week of tocolysis (all P < 0.05, adjusted for multiple comparisons). Tocolysis discontinuation prior to term is associated with late-preterm birth, adverse neonatal outcomes, and increased estimated health care costs.
Rebarber
Andrei
A
Maternal Fetal Medicine Associates, PLLC, and Mt. Sinai School of Medicine, New York, New York 10128, USA. arebarber@mfmnyc.com
Cleary-Goldman
Jane
J
Istwan
Niki
N
Rhea
Debbie
D
Stanziano
Gary
G
Saltzman
Daniel
D
D000293:Adolescent; D000328:Adult; D015897:Comorbidity; D005260:Female; D005845:Georgia / Q000453:epidemiology; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D017533:Marital Status; D008423:Maternal Age; D008875:Middle Aged; D011247:Pregnancy; D011256:Pregnancy Outcome; D011263:Pregnancy Trimester, Third; D047928:Premature Birth / Q000188:drug therapy* / Q000453:epidemiology*; D044469:Racial Groups / Q000706:statistics & numerical data; D012008:Recurrence; D012189:Retrospective Studies; D012907:Smoking / Q000453:epidemiology; D013726:Terbutaline / Q000627:therapeutic use; D015145:Tocolysis / Q000706:statistics & numerical data*; D015149:Tocolytic Agents / Q000627:therapeutic use; D055815:Young Adult
D015149:Tocolytic Agents; D013726:Terbutaline