The association of elective cessation of tocolysis and preterm birth in singleton gestations.

ABSTRACT

We evaluated outcomes following tocolysis discontinuation in singleton pregnancies between 33.0 and 36.9 weeks' gestation. We performed a retrospective analysis of singleton pregnancies prescribed continuous subcutaneous terbutaline tocolysis. Patients without indicated preterm delivery discontinuing treatment between 33.0 and 36.9 weeks were evaluated ( N = 4253). Data were grouped by week at treatment discontinuation. Outcomes were compared for each week. Approximately 55% (2316/4253) delivered preterm (< 37 weeks). After treatment discontinuation, 58.1% (2472/4253) of patients delivered within 7 days and 41.2% (1752/4253) within 3 days. Median number of days from discontinuation to delivery was 5 (range, 0 to 65). Incidence of low birth weight (< or = 2500 g), neonatal intensive care unit admissions, days in nursery, and estimated charges decreased with each additional week of tocolysis (all P < 0.05, adjusted for multiple comparisons). Tocolysis discontinuation prior to term is associated with late-preterm birth, adverse neonatal outcomes, and increased estimated health care costs.