A Comparison of Neonatal Outcomes After Inpatient Versus Outpatient Management of Vasa Previa [ID 1619]

INTRODUCTION: Inpatient admission and preterm/early term delivery are commonly recommended antenatal management strategies of vasa previa (VP); however, evidence supporting this clinical practice is sparse. Our aim was to compare neonatal outcomes after inpatient (IM) versus outpatient (OM) management of VP. METHODS: This is a retrospective cohort study of maternal–neonatal dyads from January 1, 2011, to May 1, 2023, from a single hospital system with persistent VP in the third trimester (without placenta previa). Demographics, delivery, and neonatal outcomes were collected from the electronic medical record. Using SPSS, normality of distribution was evaluated and continuous variables were compared using Mann–Whitney U test. Categorical variables were compared using chi-squared/Fisher’s exact test. RESULTS: Of 210 patients screened, 72 pregnancies met inclusion criteria (n=61 IM, n=11 OM). Demographics were similar between groups. Compared to OM, IM participants were admitted at significantly earlier gestational ages (GAs), trended toward earlier GA at delivery, and had significantly lower birth weights. Neonatal intensive care unit (NICU) admission rate was similar between the cohorts. Although NICU total length of stay was significantly longer for neonates in the IM cohort (IM: median 24 [IQR 18–35] days; OM: median 3 [IQR: 2–27] days), corrected newborn postmenstrual age at discharge did not differ. Other neonatal outcomes did not differ between groups. There were no neonatal mortalities. CONCLUSIONS/IMPLICATIONS: There is no significant difference in neonatal morbidity or mortality between IM or OM of VP. Although limited by the small sample size, a trend towards earlier delivery and longer newborn hospitalizations was seen for inpatient VP management.