Abstract
Objective: To determine if the use of fetal fibronectin (fFN) testing has affected hospital admissions for preterm labor. Methods: ICD-9 and CPT codes from all admissions to Brigham & Women’s Hospital between January 1, 1995 and December 31, 2010 were evaluated. Data recorded included total deliveries, admissions for preterm labor (PTL) without delivery, length of stay (days) for PTL admissions, preterm deliveries, and number of fFN tests performed. The data was evaluated using a Wilcoxon test of trend and least squares regression. Results: Fetal fibronectin testing was introduced mid-year 2001. As a percentage of total deliveries, the number of admissions for PTL without delivery decreased from 3.97% in 1995 to 2.16% in 2010 (p
Highlights
Preterm births continue to be the leading cause of infant mortality in the United States
The number of hospital days for admissions for preterm labor (PTL) without delivery, or antepartum admissions, per 10,000 total births decreased from 1853 days/10,000 births to 903 days/10,000 (p < 0.001) births while the number of fetal fibronectin (fFN) tests per 10,000 births increased from 0/10,000 births to 1390/ 10,000 births (p < 0.0001) as expected with introduction of fFN testing
Further logistic regression aanalysis was used to adjust for the decrease in preterm delivery and noted significant correlation between fFN use and decreased antepartum admission for PTL (p < 0.05)
Summary
Preterm births continue to be the leading cause of infant mortality in the United States. While the infant mortality rate has plateaued from 2000 until the present, the percentage of preterm births has increased. In 2005, 68.6% of infant deaths were in preterm infants, an increase from 65.6% in 2000 [1]. Along with increased rates in prematurity, the cost of health care continued to skyrocket from 2000 to 2005, and continues to increase today. In 2008, health care spending accounted for 16.2% of the United States Gross Domestic Product, surpassing 2.3 trillion dollars. Hospital care accounted for 31% of health care spending in 2008 [2]. In the current cost-conscious environment, we are increasingly looking towards costsaving prevention measures. Cost-saving measures include reducing unnecessary hospital admissions
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