MULTICENTER RANDOMIZED CLINICAL-TRIAL OF HOME UTERINE ACTIVITY MONITORING - PREGNANCY OUTCOMES FOR ALL WOMEN RANDOMIZED

OBJECTIVE: Our purpose was to evaluate the impact of home uterine acti vity monitoring on pregnancy outcomes among women at high risk for pre term labor and delivery. STUDY DESIGN: Women at high risk for preterm labor at three centers were randomly assigned to receive high-risk pre natal care alone (not monitored) or to receive the same care with twic e-daily home uterine activity monitoring without increased nursing sup port (monitored). There were 339 women with singleton gestations rando mized with caregivers blinded to group assignment. The two groups were medically and demographically similar at entry into the study. RESULT S: Women in the monitored group had prolonged pregnancy survival (p = 0.02) and were less likely to experience a preterm delivery (relative risk 0.59; p = 0.04). Infants born to monitored women with singleton g estations were less likely to be of low birth weight (<2500 gm; relati ve risk 0.47, p = 0.003), and were less likely to be admitted to a neo natal intensive care unit (relative risk 0.5, p = 0.01). CONCLUSION: T hese data show, among women with singleton gestations at high risk for preterm delivery, that the use of home uterine activity monitoring al one, without additional intensive nursing care, results in improved pr egnancy outcomes, including prolonged gestation, decreased risk for pr eterm delivery, larger-birth-weight infants, and a decreased need for neonatal intensive care.