University hospital based care decreases recurrent preterm deliveries and costs in comparison to no prenatal care

Objective: To compare perinatal outcomes and total health care costs for patients with a previous history of preterm delivery cared for by an inner city university hospital house staff clinic versus patients who have not received any prenatal care. Study Design: We conducted a retrospective review of women with a history of preterm delivery between 1994 and 1996. The inclusion criteria was a history of at least one preterm delivery. Data were obtained on maternal demographics, complete past obstetrical history, and number of prenatal visits. Results: The study groups consisted of 96 house staff patients and 53 patients without prenatal care. The number of prior preterm births, incidence of recurrent preterm delivery, length of neonatal intensive care unit stay, and mother-infant costs were greater in the group without prenatal care. The mean gestational age at time of delivery, and mean birth weight were greater in the house staff group. Conclusion: Our study demonstrates that university hospital-based prenatal care decreases recurrent preterm delivery rates and health care costs when compared to lack of prenatal care. Prenatal care provided at academic centers, with a coordinated multidisciplinary approach, appears to have a positive impact on the problem of preterm deliveries.