Association between rehabilitation during hospitalization and perinatal outcomes among pregnant women with threatened preterm birth

Abstract

Objective

This study conducted a nationwide retrospective cohort study to evaluate whether rehabilitation for pregnant women during long-term hospitalization is associated with adverse perinatal events.

Methods

We performed a retrospective cohort study using a diagnosis procedure combination (DPC) database, a national inpatient database for acute-care inpatients in Japan. Hospitalized pregnant women diagnosed with threatened preterm birth, who stayed in the hospital for 7 days or longer from July 2010 to March 2017 in Japan were identified. One-to-four propensity score-matched analyses were performed to compare perinatal outcomes between patients with and without rehabilitation during hospitalization. The primary outcome was preterm birth (<35/0 weeks of gestation) during hospitalization.

Results

Of the 141,705 eligible patients, 351 (0.25%) received any type of rehabilitation during hospitalization. One-to-four propensity score matching created a rehabilitation group (n = 338) and a nonrehabilitation group (n = 1352). The propensity-matched analysis showed that the proportion of preterm births in the rehabilitation group was lower than that in the nonrehabilitation group (5.9% versus 8.9%; risk difference: −3.0%; 95% confidence interval (CI): −5.9 to −0.03).

Conclusions

This retrospective nationwide study suggests that rehabilitation for hospitalized patients with threatened preterm birth may reduce the risk of preterm birth.

Brief rationale

In this nationwide study, we suggest that rehabilitation for long-term hospitalized patients with threatened preterm birth may reduce the risk of preterm birth.

Keywords:

• Cesarean section
• physical therapy
• preterm birth
• rehabilitation

Availability of data and materials

The datasets analyzed in this study are not publicly available for ethical reasons because they include patient data but are available from the corresponding author on reasonable request.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This work was supported by the Ministry of Health, Labor and Welfare, Japan [grant number H30-Policy-Designated-004, H29-ICT-General-004 to HY]. The funding organization had no role in planning the research, conducting the analysis, interpreting the results, or writing the report.