Use of prenatal corticosteroids for preterm birth in three Latin American countries

Riganti, Alicia Aleman; Cafferata, María Luisa; Althabe, Fernando; Gibbons, Luz; Segarra, José Ignacio Ortíz; Sandoval, Xochitl; Belizán, José M.

doi:10.1016/j.ijgo.2009.08.022

Cited by 10 publications

(7 citation statements)

References 10 publications

(5 reference statements)

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“…In the present study of women who delivered between 24-and 34-weeks' gestation, only 35.3% were administered ACS. This is consistent with a study conducted in Ecuador [26]. In contrast, some studies conducted in low-and middle-income countries have also reported low rates of ACS use, e.g in Malawi (10%), Democratic Republican of Congo (16%), Nepal (20%), Uganda (27%), Nigeria (30%) and Kenya (32%) [27,28], while others conducted in South East Asia have reported a higher use of ACS (40%) [29].…”

Section: Plos Onesupporting

confidence: 93%

Association between antenatal corticosteroid use and perinatal mortality among preterm births in hospitals in Tanzania

et al. 2021

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Objectives The primary aims of this study were to investigate if exposure to antenatal corticosteroids (ACS) was associated with lower rates of perinatal mortality (primary outcome) and other adverse perinatal outcomes (i.e., stillbirth, early neonatal mortality, APGAR score of < 7 at 5 mins, neonatal sepsis and respiratory distress syndrome) in preterm infants in hospitals in Tanzania. We also examine factors associated with administration of ACS among women at risk of preterm delivery. Methods A hospital-based prospective chart review study was undertaken in four hospitals located in Nyamagana and Sengerema districts, Tanzania. The study population included all stillborn and live born preterm infants delivered between 24 to 34 weeks of gestation between July 2019 to February 2020. A total 1125 preterm infants were delivered by 1008 women (895 singletons, 230 multiple). Sociodemographic and medical data were recorded from participants’ medical records. Results Three hundred and fifty-six (35.3%) women were administered at least one dose of ACS between 24 to 34 weeks’ gestation and 385 (34.2%) infants were exposed to ACS. Infants exposed to ACS had a lower rate of perinatal mortality (13.77%) compared to those who were not exposed (28.38%). Multivariate analysis indicated that infants exposed to ACS were less likely to die during perinatal period, aRR 0.34 (95%CI 0.26-0.44). Only one-third of the sample was provided with ACS. Administration of ACS was associated with maternal education, attending antenatal care more than 3 times, method used to assess gestational age, maternal infection, exposure to maternal antibiotics, delivery mode and level of health facility. Conclusion ACS significantly reduced the risk in perinatal mortality among infants born preterm in a limited resource setting. However, only about one-third of eligible women were provided with ACS, indicating low usage of ACS. Numerous factors were associated with low usage of ACS in this setting.

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Section: Plos Onesupporting

confidence: 93%

Association between antenatal corticosteroid use and perinatal mortality among preterm births in hospitals in Tanzania

et al. 2021

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“…Regardless of around 90% of providers reporting that they use ACT in TPL, information obtained from women having preterm births in the same hospitals showed figures of 34.8%, 54.6%, and 71% in Ecuador, El Salvador and Uruguay, respectively of ACT use [9]. Reasons explaining such discrepancy needs to be subject of analysis and actions to improve the reception of ACT on pregnancies that finally end in preterm birth.…”

Section: Resultsmentioning

confidence: 99%

“…Ecuador had the lowest use (34.8%), followed by El Salvador (54.6%), and Uruguay (71%) and the maternal characteristics associated with their use [9]. …”

Section: Introductionmentioning

confidence: 99%

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

Alemán

Cafferata²,

Gibbons

et al. 2013

Reprod Health

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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.

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“…In this study, all moms at risk of preterm delivery received betamethasone, the sole prenatal corticosteroid administered. In contrast to studies conducted around the world, where prenatal corticosteroids use ranged between 40% and 70% [7][8][9] in impoverished countries and 70-80% [10,11] in wealthy countries, the prevalence of use of antenatal corticosteroids was 70% in the Prathima labor ward. Just 10% of pre-term infants in low-and middle-income countries presently get prenatal corticosteroids.…”

Section: Discussionmentioning

confidence: 60%

Impact of Corticosteroids on Perinatal Outcome

KSK,

SAHITHI,

GEDALA

2023

Asian J Pharm Clin Res

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Objective: The study’s main aim was to demonstrate the efficacy of antenatal corticosteroids (betamethasone) to prevent respiratory distress syndrome (RDS) and other related complications in premature babies and to study the outcomes of neonates whose mothers received corticosteroids during the antenatal period. Methods: A total of 50 pregnant women with a risk of preterm delivery admitted to the labor ward of Prathima Institute of Medical Sciences were included in the study. It is a prospective, hospital-based, and longitudinal study. All women coming to the antenatal outpatient department of Prathima Institute of Medical Sciences who are at risk of preterm delivery were selected. The follow-up component of the study involved women identified as at high risk for premature delivery and who had received betamethasone. The neonatologist diagnosed the neonatal complications was taken as an outcome. Results: Of the 50 babies that were enrolled in the study, 27 (54%) were delivered by spontaneous vaginal delivery, 1 by assisted breech (2%), 1 by instrumental delivery (2%), and 18 (36%) were delivered by cesarean section. The occurrence of RDS among babies with low APGAR was 4 (44.44%). Only one intraventricular hemorrhage occurred among the category, with a low APGAR score (11.11%). Out of 19 cases, ten deaths were identified, and nine were alive within 24 h due to the action of steroids. Among 31 cases, two cases were death, and 29 were alive after 24 h of the duration of action of steroid. Even though mothers of all babies in this study admitted to the neonatal unit had received corticosteroids, there was still 24% mortality by 28 days. The results suggest that once admitted to NICU, having only received a single dose of corticosteroids <24 h previously (as opposed to more than 24 h), gestational age <34 weeks, and having any listed neonatal complications were associated with mortality by 28 days. Conclusion: Even though 50% of the neonates suffered complications, over 40% of the subjects were delivered before betamethasone could take effect. Several other factors, apart from betamethasone, influenced the outcome of neonates. The present study showed that the use of ANCS administration is the single most intervention to prevent complications of prematurity which can be done at a public health center or by a private practitioner, even in rural areas.

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Use of prenatal corticosteroids for preterm birth in three Latin American countries

Cited by 10 publications

References 10 publications

Association between antenatal corticosteroid use and perinatal mortality among preterm births in hospitals in Tanzania

Association between antenatal corticosteroid use and perinatal mortality among preterm births in hospitals in Tanzania

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

Impact of Corticosteroids on Perinatal Outcome

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