Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2011 Mar;117(3):603-609.
doi: 10.1097/AOG.0b013e31820c3c9b.

Antenatal steroid administration for premature neonates in California

Henry C Lee  1 , Audrey Lyndon, Yair J Blumenfeld, R Adams Dudley, Jeffrey B Gould
Affiliations

Antenatal steroid administration for premature neonates in California

Henry C Lee et al. Obstet Gynecol. 2011 Mar.

Abstract

Objectives: To estimate risk factors for premature neonates not receiving antenatal steroids in a population-based cohort and to determine whether the gains of a quality-improvement collaborative project on antenatal steroid administration were sustained long-term.

Methods: Clinical data for premature neonates born in 2005–2007 were obtained from the California Perinatal Quality Care Collaborative, which collects data on more than 90% of neonatal admissions in California. Eligible neonates had a birth weight of less than 1,500 g or gestational age less than 34 weeks and were born at a Collaborative hospital. These data were linked to administrative data from California Vital Statistics. Sociodemographic and medical risk factors for not receiving antenatal steroids were determined. We also examined the effect of birth hospital participation in a previous quality-improvement collaborative project. A random effects logistic regression model was used to determine independent risk factors.

Results: Of 15,343 eligible neonates, 23.1% did not receive antenatal steroids in 2005–2007. Hispanic mothers (25.6%), mothers younger than age 20 (27.6%), and those without prenatal care (52.2%) were less likely to receive antenatal steroids. Mothers giving birth vaginally (26.8%) and mothers with a diagnosis of fetal distress (26.5%) were also less likely to receive antenatal steroids. Rupture of membranes before delivery and multiple gestations were associated with higher likelihood of antenatal steroid administration. Hospitals that participated in a quality-improvement collaborative in 1999– 2000 had higher rates of antenatal steroid administration (85% compared with 69%, P<.001).

Conclusion: A number of eligible mothers do not receive antenatal steroids. Quality-improvement initiatives to improve antenatal steroid administration could target specific high-risk groups.

PubMed Disclaimer

Conflict of interest statement

Financial Disclosure: The authors did not report any potential conflicts of interest.

Figures

Figure 1
Figure 1
Antenatal steroid administration by gestational age.
Figure 2
Figure 2
Adjusted rates of antenatal steroid administration by hospital. Rates were risk adjusted using a random effects logistic regression model. Adjusted rates for the majority of hospitals were lower than actual crude rates.
See this image and copyright information in PMC

References

    1. Liggins GC, Howie RN. A controlled trial of antepartum glucocorticoid treatment for prevention of the respiratory distress syndrome in premature infants. Pediatrics. 1972 Oct;50(4):515–25. - PubMed
    1. Crowley P. Prophylactic corticosteroids for preterm birth. Cochrane Database Syst Rev. 2000;2:CD000065. - PubMed
    1. ACOG Committee Opinion No. 402: Antenatal corticosteroid therapy for fetal maturation. Obstet Gynecol. 2008 Mar;111(3):805–7. - PubMed
    1. ACOG committee opinion. Antenatal corticosteroid therapy for fetal maturation. Number 210, October 1998 (Replaces Number 147, December 1994). Committee on Obstetric Practice. American College of Obstetricians and Gynecologists. Int J Gynaecol Obstet. 1999 Mar;64(3):334–5. - PubMed
    1. Miracle X, Di Renzo GC, Stark A, Fanaroff A, Carbonell-Estrany X, Saling E. Guideline for the use of antenatal corticosteroids for fetal maturation. J Perinat Med. 2008;36(3):191–6. - PubMed

Publication types

Substances