Factors associated with the use of prenatal corticosteroids in the management of preterm delivery in Chinese hospitals.

Autor: Wang X; Department of Child, Adolescent and Women's Health, Peking University, Beijing, China; Key Laboratory of Reproductive Health, Ministry of Health, Beijing, China., Vogel JP; School of Population Health, University of Western Australia, Perth, WA, Australia; Department of Reproductive Health and Research, World Health Organization, Geneva, Switzerland., Kang CY; Department of Child, Adolescent and Women's Health, Peking University, Beijing, China; Key Laboratory of Reproductive Health, Ministry of Health, Beijing, China., Gao YQ; Department of Child, Adolescent and Women's Health, Peking University, Beijing, China; Key Laboratory of Reproductive Health, Ministry of Health, Beijing, China., Ao D; Department of Child, Adolescent and Women's Health, Peking University, Beijing, China; Key Laboratory of Reproductive Health, Ministry of Health, Beijing, China., Pang RY; Department of Child, Adolescent and Women's Health, Peking University, Beijing, China; Key Laboratory of Reproductive Health, Ministry of Health, Beijing, China., Wang Y; Department of Child, Adolescent and Women's Health, Peking University, Beijing, China; Key Laboratory of Reproductive Health, Ministry of Health, Beijing, China. Electronic address: wangyan@bjmu.edu.cn.
Jazyk: angličtina
Zdroj: International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics [Int J Gynaecol Obstet] 2014 Dec; Vol. 127 (3), pp. 260-4. Date of Electronic Publication: 2014 Jul 24.
DOI: 10.1016/j.ijgo.2014.05.026
Abstrakt: Objective: To assess the prevalence of the use of prenatal corticosteroids (PCS) in the management of preterm delivery and the factors associated with PCS administration.
Methods: A secondary analysis was performed of a cross-sectional study conducted in 21 Chinese healthcare facilities between November 2010 and January 2011. The medical records of women who delivered preterm were reviewed. Associations between PCS administration and individual and organizational-level factors were determined.
Results: The study population comprised 659 women who delivered at 20 facilities. PCS were given to 158 (68.1%) of 232 women delivering after 27-34 weeks of pregnancy and 119 (27.9%) of 427 delivering after 35-36 weeks. Teenaged girls were less likely to receive PCS after 27-34 weeks than were women aged 20-35 years (odds ratio [OR] 0.22; 95% confidence interval [CI] 0.07-0.70). Among women who delivered after 35-36 weeks, the odds of receiving PCS were lower in urban hospitals than in periurban or rural hospitals (OR 0.04; 95% CI 0.00-0.44), and there was significant hospital-level variance with regard to the administration of PCS (P<0.05).
Conclusion: Generally, PCS were underprescribed to women at risk of preterm delivery and many women received the treatment after 35-36 weeks of pregnancy, when it might not have been effective.
(Copyright © 2014. Published by Elsevier Ireland Ltd.)
Databáze: MEDLINE
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