Association between rehabilitation during hospitalization and perinatal outcomes among pregnant women with threatened preterm birth

Abstract

Objective This study conducted a nationwide retrospective cohort study to evaluate whether rehabilitation for pregnant women during long-term hospitalization is associated with adverse perinatal events. Methods We performed a retrospective cohort study using a diagnosis procedure combination (DPC) database, a national inpatient database for acute-care inpatients in Japan. Hospitalized pregnant women diagnosed with threatened preterm birth, who stayed in the hospital for 7 days or longer from July 2010 to March 2017 in Japan were identified. One-to-four propensity score-matched analyses were performed to compare perinatal outcomes between patients with and without rehabilitation during hospitalization. The primary outcome was preterm birth (<35/0 weeks of gestation) during hospitalization. Results Of the 141,705 eligible patients, 351 (0.25%) received any type of rehabilitation during hospitalization. One-to-four propensity score matching created a rehabilitation group (n = 338) and a nonrehabilitation group (n = 1352). The propensity-matched analysis showed that the proportion of preterm births in the rehabilitation group was lower than that in the nonrehabilitation group (5.9% versus 8.9%; risk difference: −3.0%; 95% confidence interval (CI): −5.9 to −0.03). Conclusions This retrospective nationwide study suggests that rehabilitation for hospitalized patients with threatened preterm birth may reduce the risk of preterm birth. Brief rationale In this nationwide study, we suggest that rehabilitation for long-term hospitalized patients with threatened preterm birth may reduce the risk of preterm birth.