Trends in Hospitalization for Preterm Labor Without Delivery in the United States, 2007–2014 [A210

Abstract

INTRODUCTION: Hospitalizations for suspicion of preterm labor are often discharged without delivery, which incurs significant socioeconomic costs. Using the National Inpatient Sample, we seek to describe the epidemiology of these preterm labor admissions that do not result in delivery and evaluate associated trends over time. METHODS: The National Inpatient Sample, years 2007–2014, was queried for all discharges containing the ICD-9 code for preterm labor. Data describing age, ethnicity, primary payer, length of admission, and total hospital charges were analyzed. Weighted regression analysis was used to identify trends in continuous variables and regression models were used to evaluate trends in proportion of race and insurance coverage. RESULTS: The estimated number of qualifying discharges per year decreased from 88,955 in 2007 to 52,970 in 2014. The ratio of admissions for preterm labor without delivery to admissions for preterm labor resulting in delivery decreased from 1:3.76 to 1:4.32 (P trend <.01). Estimated adjusted mean total hospital costs increased from $12,223 to $15,438 (P trend <.01). The proportion of discharges with Medicaid and “other” insurance coverage changed significantly from 48.6% to 54.82% (P trend =.03) and 9.68% to 7.9% (P trend =.05), respectively. Mean length of stay, changes in proportion of race, and changes in coverage by private insurance were not significant. CONCLUSION: A decreased ratio of undelivered to delivered preterm labor discharges over time may indicate that identification of true preterm labor is improving. However, increasing hospitalization costs with an increasing proportion of patients covered by Medicaid has concerning implications. Further study on the epidemiology of resolved preterm labor may improve the cost-effectiveness of future patient care.