Use of antenatal corticosteroids for preterm birth in Latin America: providers knowledge, attitudes and practices

Abstract

BackgroundAntenatal corticosteroids administered to women at risk of preterm birth is an intervention which has been proved to reduce the risk of respiratory distress syndrome, intraventricular hemorrhage, and neonatal mortality. There is a significant gap in the literature regarding the prevalence of the use of antenatal corticosteroids in Latin American countries and the attitudes and opinions of providers regarding this practice. The aim of this study was to assess the knowledge, attitudes and practices of health care providers regarding the use of antenatal corticosteroids in women at risk of preterm birth in Latin America.MethodsThis was a multicenter, prospective, descriptive study conducted in maternity hospitals in Ecuador, El Salvador, Mexico and Uruguay. Physicians and midwives who provide prenatal care or intrapartum care for women delivering in the selected hospitals were approached using a self-administered questionnaire. Descriptive statistics was used.ResultsThe percentage of use of ACT in threatened preterm labour (TPL) reported by providers varies from 70% in Mexico to 97% in Ecuador. However, 60% to 20% of the providers mentioned that they would not use this medication in women at risk and would limit its use when there was a threatened preterm labour. In only one country recommended regimens of antenatal corticosteroids are followed by around 90% of providers whereas in the other three countries recommended regimens are followed by only 21%, 61%, 69% of providers. Around 40% of providers mentioned that they would administer a new dose of corticosteroids again, regardless the patient already receiving an entire regimen. Between 11% and 35% of providers, according to the countries, mentioned that they do not have adequate information on the correct use of this medication.ConclusionsThis study shows that the use of this intervention could be improved by increasing the knowledge of Latin American providers on its indications, benefits, and regimens.

Effect of maternal near miss on neonatal mortality in selected hospitals: Prospective cohort study, Southeast Ethiopia

“…4 Proportion of cesarean delivery is lower in this study when compared with findings of two studies from Kenya and Pakistan. 23 , 24 This might be because women in this area prefer to have spontaneous vaginal delivery. Current stillbirth was also higher than what were found in other studies conducted in Ethiopia and Pakistan.…”

“…This study was consistent with other studies conducted by various authors in different parts of the world. 8 , 9 , 23 , 24 , 28 - 30 This might because severe maternal morbidity affects well-being of baby. Neonatal birth weight was found as not statistically significant factors for neonatal mortality.…”

Neonatal mortality and associated factors in newborn infants admitted to a Neonatal Care Unit

“…Based on the findings of this study, it is important to know and implement interventions aimed at improving survival among preterm patients, such as specialized care during pregnancy and labor, 2,18,19 antenatal corticosteroid use, 20 and breastfeeding in the first 24 hours, 21 and to increase the resources allocated to health care. 22,23 The limitations of this study are that it was conducted in a hospital sample that may be different from the general population and that the sample was too small to establish specific subgroups, such as mothers < 15 years or who received no antenatal care at all.…”

Evaluation of prenatal corticosteroid use in spontaneous preterm labor in the Brazilian Multicenter Study on Preterm Birth (EMIP)

“…When compared with other studies of preterm delivery, a relatively low incidence of prenatal corticosteroid use was identified in the present study but it is important to emphasize that the data analyzed evaluated only pregnancies that continued to delivery. Certainly, if all patients who received prenatal corticosteroids in preterm labor were considered, including those who did not progress to delivery (which was not the purpose of the present study), that number would be higher.…”