Quantification of nursery length of stay by gestational age at delivery and plurality

Abstract

DELIVERY AND PLURALITY FUNG LAM, DEBBIE RHEA, NIKI ISTWAN, GARY STANZIANO, ELLIOTT MAIN, California Pacific Medical Center, Ob/Gyn, San Francisco, California, Matria Healthcare, Clinical Research, Marietta, Georgia OBJECTIVE: To determine gestational age (GA) related neonatal outcomes and economic impact associated with prematurity. STUDY DESIGN: From a database we identified non-anomalous, live-born infants from singleton, twin, and triplet pregnancies with non-indicated delivery at 24-37 weeks. Records were examined for nursery utilization and length of stay. Neonatal deaths were excluded. Nursery charges were modeled: $500/day regular, $1200/day intermediate, and $2000/day for NICU. Higher-level nursery (HLN =NICU/ Intermediate) admission, nursery days and charges were compared by GA at delivery (GAD) in weeks and gestational type. RESULTS: Data from 26,264 singletons, 14,147 twins, and 3196 triplets representing 34,435 pregnancies were analyzed. Each additional infant significantly increased nursery stay and related charges for each successive GAD week between 27 and 37 (all P ! .05). Each additional week in utero resulted in substantially lower nursery days and charges for singletons (weeks 25-37), twins (weeks 27-37) and triplets (weeks 27-36) (all P ! .05). SMFM Abstracts S107