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Specialized care for twin gestations: improving newborn outcomes and reducing costs
R J Ruiz1, C E Brown, M T Peters
1University of Texas Health Science Center, San Antonio, USA. Ruizr@uthscsa.edu
Objective:
To compare newborn outcomes and costs of hospital stays for twins born to mothers receiving care in a specialized twin clinic with a research-based care protocol and one consistent caregiver versus twins whose mothers received standard prenatal care.
Design And Setting:
A retrospective, historical cohort study conducted in a high-risk obstetric clinic in central Texas.
Patients:
Thirty women pregnant with twins received specialized care. The comparison group consisted of 41 women pregnant with twins who received standard care.
Interventions:
An advanced practice nurse provided prenatal care, which included weekly clinic visits, home visits, and 24-hour availability for phone support.
Outcome Measures:
Gestational age at birth, birth weight, length of stay in the neonatal intensive-care unit (NICU), and hospital charges for the newborns.
Results:
No newborns of less than 30 weeks gestation were born to women in the specialized care group, the mean birth weight was 249 g (SD +/- 77) higher, days in the NICU were reduced from a mean of 17 to 7, and hospital charges were $30,000 less per infant.
Conclusions:
Newborn outcomes were improved and length of stay and hospital charges were significantly reduced for newborns whose mothers had received care in the specialized twin clinic.