Pregnancy and economic outcomes in patients treated for recurrent preterm labor

Abstract

Objective: To compare clinical and cost-effectiveness of treating recurrent preterm labor (RPTL) with oral nifedipine versus continuous subcutaneous terbutaline infusion (SQT). Study Design: Women with singleton gestations prescribed nifedipine for tocolysis following first diagnosis of preterm laber were identified. Women hospitalized with RPTL at <34 weeks were matched by gestational age (GA) after resuming nifedipine (NIF group) with women prescribed SQT (SQT group) after stabilization. Healthcare utilization costs were modeled and compared. Results: This study analyzed 142 matched pairs. GA at RPTL (matched variable) was 30.4 ± 3.1 weeks versus 36.6 ± 2.1 weeks, p = 0.004). Overall, infants from the NIF group had lower birth weights and higher nursery days than infants from the SQT group. Healthcare utilization costs were greater in the NIF group versus the SQT group ($37,040 ± 47,518 versus 26,546 ± 25,386, p = 0.014). Conclusion: Treating RPTL with SQT versus oral nifedipine resulted in a later GA at delivery, improved neonatal outcome, and increased cost-effectiveness.