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.
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.
Authors: Elizabeth Sebastian; Chloe Bykersma; Alexander Eggleston; Katherine E Eddy; Sher Ting Chim; Rana Islamiah Zahroh; Nick Scott; Doris Chou; Olufemi T Oladapo; Joshua P Vogel Journal: EClinicalMedicine Date: 2022-06-03
Authors: M Brad Sullivan; Abby Rentz; Pamela Mathura; Megan Gleddie; Tania Luthra; Allison T Thiele; Katharina Kovacs Burns; Rebecca Rich; Winnie W Sia Journal: BMJ Open Qual Date: 2022-01