复发性早产患者的妊娠及经济结局

Pregnancy and economic outcomes in patients treated for recurrent preterm labor.

作者信息

Fleming Alfred, Bonebrake Robert, Istwan Niki, Rhea Debbie, Coleman Suzanne, Stanziano Gary

机构信息

Department of Obstetrics and Gynecology, Creighton University Medical Center, Omaha, NE 68131, USA.

出版信息

J Perinatol. 2004 Apr;24(4):223-7. doi: 10.1038/sj.jp.7211058.

DOI:10.1038/sj.jp.7211058

PMID:14999214

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 labor 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+/-2.6 weeks. GA at delivery was earlier in the NIF group versus the SQT group (35.7+/-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 US dollars versus 26,546+/-25,386 US dollars, 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.

摘要

目的

比较口服硝苯地平与皮下持续输注特布他林治疗复发性早产（RPTL）的临床效果和成本效益。

研究设计

确定首次诊断早产时接受硝苯地平保胎治疗的单胎妊娠女性。孕周<34周因RPTL住院的女性，在重新使用硝苯地平后（硝苯地平组），按孕周（GA）与病情稳定后接受皮下持续输注特布他林治疗的女性（特布他林组）进行匹配。对医疗资源利用成本进行建模并比较。

结果

本研究分析了142对匹配病例。RPTL时的GA（匹配变量）为30.4±2.6周。硝苯地平组的分娩孕周早于特布他林组（35.7±3.1周对36.6±2.1周，p = 0.004）。总体而言，硝苯地平组婴儿的出生体重低于特布他林组，在新生儿重症监护室的天数多于特布他林组。硝苯地平组的医疗资源利用成本高于特布他林组（37,040±47,518美元对26,546±25,386美元，p = 0.014）。