Promoting antenatal steroid use for fetal maturation: Results from the California Perinatal Quality Care Collaborative

Regional Variation in Antenatal Corticosteroid Use: A Network-Level Quality Improvement Study

“…16 Wirtschafter et al showed improvements in ACU after a CPQCC Quality Collaborative among 25 NICUs with the median rates increasing from 80% to 87.8%. 9 Howell et al noted that 20% of infants in 3 NICUs in New York City failed to receive antenatal corticosteroids. 17 Lee et al found similar results across 128 NICUs in California.…”

“…7,8 In 1998, a collaborative quality improvement effort sponsored by the California Perinatal Quality Care Collaborative (CPQCC) was successful in improving ACU rates from 76% to 86% among 25 participating NICUs. 9 However, collaborative quality improvement efforts only reach a small proportion of the state's 140 NICUs and those that volunteer to participate are not a representative sample. For all NICUs to improve their ACU rates, a new approach to quality improvement is needed.…”

The smallest of the small: short-term outcomes of profoundly growth restricted and profoundly low birth weight preterm infants

“…As such, the CPQCC has proven to be a valuable tool to audit and improve care of preterm babies in California and provides a broad and rich data set to inform medical and parental decision making for these high-risk infants. [3][4][5][6] The current study was a retrospective database review of births o 32 weeks gestation and o 1500 g birth weight reported to the CPQCC between 2005 and 2012. Profoundly SGA (ProSGA, birth weight o 1st centile for age) and profoundly low birth weight (ProLBW, birth weight 300 to 500 g) subjects were identified, and comparisons were made between the ProSGA infants and appropriate for gestational age infants (AGA, 5 th to 95th weight centile at birth) and between ProLBW and very low birth weight (VLBW) infants (birth weight 501 to 1500 g).…”

Referral of Very Low Birth Weight Infants to High-Risk Follow-Up at Neonatal Intensive Care Unit Discharge Varies Widely across California

“…Maternal, sociodemographic, neonatal clinical, and NICU-related data were obtained through CPQCC records, using definitions as described in previous publications. 18,19 For the purposes of this analysis, prenatal care was defined categorically, maternal age was grouped as #19 years, 20-29 years, and subsequent 10 year intervals to 40+ years, and maternal race/ethnicity was categorized according to CCS guidelines (African American, Hispanic, white, Asian/Pacific Islander, native American, other). Other factors included morbidities that may have contributed to severity of illness, such as necrotizing enterocolitis (NEC), late sepsis, or meningitis (culture-proven sepsis and/or meningitis after day 3), surgery for retinopathy of prematurity, patent ductus arteriosus, or NEC, presence of congenital anomalies, oxygen use at 36 weeks postmenstrual age (PMA) (continuous or intermittent), and severe intraventricular hemorrhage (IVH).…”