REDUCTION OF PRETERM BIRTHS IN A LOW-INCOME POPULATION UTILIZING HOMEUTERINE ACTIVITY MONITORING

Background: The combined use of home uterine activity monitoring (HUAM ) and intensive perinatal nursing support (PNS) in patients at risk fo r preterm birth (PTB) has been associated with earlier diagnosis of id iopathic preterm labor (PTL), and an increase in term deliveries. Most women using this modality have private health insurance and are in mi ddle or upper income groups. Objective: To assess the value of HUAM PNS in extending gestation to greater-than-or-equal-to 37 weeks durati on, and in maximizing newborn birth weight and outcome in high-fisk, l ow-income pregnant women. Methods: In this prospective, matched, cohor t study, 38 Medicaid patients at risk for preterm labor using HUAM + P NS were matched as a group forage, race, parity, and any of three risk factors for PTL with a group of 38 other Medicaid patients not using HUAM + PNS. Results: Monitored patients were more likely to deliver at term, the gestational ages of their newborns were greater, the interv al from the diagnosis of PTL to delivery was longer, birth weight was heavier, and their infants were less likely to be admitted to the neon atal intensive care unit (NICU) than those in the control group. Concl usions: These results demonstrate that a comprehensive system of HUAM + PNS, administered under a managed care mechanism, can benefit low-in come women covered by Medicaid in a manner similar to that previously demonstrated in higher-income women having private health insurance.