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

Abstract

ObjectiveTo assess the prevalence of the use of prenatal corticosteroids (PCS) in the management of preterm delivery and the factors associated with PCS administration. MethodsA 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. ResultsThe study population comprised 659 women who delivered at 20 facilities. PCS were given to 158 (68.1%) of 232 women delivering after 27–34weeks of pregnancy and 119 (27.9%) of 427 delivering after 35–36weeks. Teenaged girls were less likely to receive PCS after 27–34weeks than were women aged 20–35years (odds ratio [OR] 0.22; 95% confidence interval [CI] 0.07–0.70). Among women who delivered after 35–36weeks, 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). ConclusionGenerally, PCS were underprescribed to women at risk of preterm delivery and many women received the treatment after 35–36weeks of pregnancy, when it might not have been effective.