Clinical and economic outcomes of preterm labor management: inpatient vs outpatient

J Perinatol. 2004 Aug;24(8):515-9. doi: 10.1038/sj.jp.7211139.

Abstract

Objective: To compare pregnancy and economic outcomes in women receiving inpatient vs outpatient tocolysis with continuous subcutaneous terbutaline (SQT).

Study design: 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.

Conclusion: Outpatient management resulted in improved pregnancy outcomes at a cost less than that of inpatient management in this analysis of women treated with SQT.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Ambulatory Care / economics
  • Drug Administration Schedule
  • Female
  • Georgia / epidemiology
  • Gestational Age
  • Hospital Costs
  • Hospitalization / economics
  • Humans
  • Infant, Newborn
  • Injections, Subcutaneous
  • Obstetric Labor, Premature / drug therapy*
  • Obstetric Labor, Premature / economics*
  • Outcome Assessment, Health Care*
  • Perinatal Care / economics*
  • Perinatal Care / methods
  • Pregnancy
  • Terbutaline / administration & dosage
  • Terbutaline / therapeutic use*
  • Tocolytic Agents / administration & dosage
  • Tocolytic Agents / therapeutic use*

Substances

  • Tocolytic Agents
  • Terbutaline