Specialized care for twin gestations: improving newborn outcomes and reducing costs

J Obstet Gynecol Neonatal Nurs. 2001 Jan-Feb;30(1):52-60.

Abstract

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.

MeSH terms

  • Adult
  • Birth Weight
  • Cost Control
  • Female
  • Gestational Age
  • Hospital Charges / statistics & numerical data
  • Humans
  • Infant, Newborn
  • Length of Stay / economics
  • Maternal-Child Nursing / organization & administration*
  • Nurse Practitioners / organization & administration*
  • Nursing Evaluation Research
  • Outcome Assessment, Health Care
  • Pregnancy
  • Pregnancy Outcome* / epidemiology
  • Pregnancy, High-Risk*
  • Prenatal Care / organization & administration*
  • Retrospective Studies
  • Texas / epidemiology
  • Twins*