Clinical and Economic Outcomes of Preterm Labor Management: Inpatient Vs Outpatient

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.