Document Detail


Is 34 weeks an acceptable goal for a complicated singleton pregnancy?
MedLine Citation:
PMID:  12415908     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To examine neonatal risk and associated nursery costs for infants with delivery following untreated preterm labor at 34, 35, or 36 weeks' gestation, by assessing the incidence of neonatal intensive care unit (NICU) admission, respiratory distress syndrome (RDS), and need for ventilatory assistance. DESIGN: Infants with preterm birth at 34, 35, or 36 weeks were identified from a database of prospectively collected clinical information and pregnancy outcomes of women receiving outpatient preterm-labor management services, in addition to routine prenatal care. Cases of singleton gestations with delivery related to spontaneous preterm labor were analyzed. Data were divided into three groups by gestational week at delivery. METHODOLOGY: Descriptive and statistical methods were used to compare maternal demographics, pregnancy outcome, and nursery costs. A cost model was utilized. PRINCIPAL FINDINGS: 2849 infants were studied. Risk of NICU admission decreased by 47.4 percent from weeks 34 to 35 and 41.8 percent from weeks 35 to 36. Risk of RDS decreased by 25.4 percent from weeks 34 to 35, and 40.7 percent from weeks 35 to 36. Mean nursery costs per infant delivering at 34, 35, and 36 weeks were $11,439 +/- $19,774, $5,796 +/- $11,858, and $3,824 +/- $9,135, respectively (p < .001). CONCLUSION: Rates of NICU admission, RDS, ventilator use, and nursery-related costs decreased significantly with each week gained. The data indicate that benefit is derived in prolonging pregnancy beyond 34 weeks.
Authors:
J Stephen Jones; Niki B Istwan; Debbie Jacques; Suzanne K Coleman; Gary Stanziano
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Managed care (Langhorne, Pa.)     Volume:  11     ISSN:  1062-3388     ISO Abbreviation:  Manag Care     Publication Date:  2002 Oct 
Date Detail:
Created Date:  2002-11-05     Completed Date:  2002-11-26     Revised Date:  2005-11-17    
Medline Journal Info:
Nlm Unique ID:  9303583     Medline TA:  Manag Care     Country:  United States    
Other Details:
Languages:  eng     Pagination:  42-7     Citation Subset:  H    
Affiliation:
McLeod Regional Medical Center, McLeod Medical Park-East, 901 E. Cheves St., Ste. 430, Florence, SC 29506, USA. jonescpob@aol.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Analysis of Variance
Female
Health Services Research
Hospital Costs / statistics & numerical data*
Humans
Infant, Newborn
Infant, Premature*
Intensive Care Units, Neonatal / economics*,  utilization*
Nurseries, Hospital / economics
Obstetric Labor, Premature / economics*,  prevention & control
Pregnancy
Pregnancy Trimester, Third
Respiration, Artificial / economics*
Respiratory Distress Syndrome, Newborn / economics*
Risk Assessment
Tocolysis / adverse effects,  utilization
United States

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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