Use of antenatal corticosteroids among infants with gestational age at 24 to 31 weeks in 57 neonatal intensive care units of China: a cross-sectional study.
10.1097/CM9.0000000000002266
- Author:
Jing ZHAO
1
;
Zongtai FENG
2
;
Yun DAI
2
;
Wanxian ZHANG
1
;
Siyuan JIANG
3
;
Yanchen WANG
4
;
Xinyue GU
4
;
Jianhua SUN
5
;
Yun CAO
3
;
Shoo K LEE
6
;
Xiuying TIAN
1
;
Zuming YANG
2
Author Information
1. Division of Neonatology, Tianjin Central Hospital of Obstetrics and Gynecology, Tianjin 300052, China.
2. Division of Neonatology, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, Jiangsu 215002, China.
3. Division of Neonatology, Children's Hospital of Fudan University, Shanghai 201102, China.
4. NHC Key Laboratory of Neonatal Diseases, Fudan University, Children's Hospital of Fudan University, Shanghai 201102, China.
5. Department of Neonatology, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China.
6. Maternal-Infants Care Research Centre, Mount Sinai Hospital, Toronto, ON M5G 1X5, Canada.
- Collective Name:Chinese Neonatal Network (CHNN)
- Publication Type:Journal Article
- MeSH:
Humans;
Infant, Newborn;
Infant;
Pregnancy;
Female;
Gestational Age;
Infant, Premature;
Intensive Care Units, Neonatal;
Cross-Sectional Studies;
Adrenal Cortex Hormones/therapeutic use*
- From:
Chinese Medical Journal
2023;136(7):822-829
- CountryChina
- Language:English
-
Abstract:
BACKGROUND:Antenatal corticosteroids (ACS) can significantly improve the outcomes of preterm infants. This study aimed to describe the ACS use rates among preterm infants admitted to Chinese neonatal intensive care units (NICU) and to explore perinatal factors associated with ACS use, using the largest contemporary cohort of very preterm infants in China.
METHODS:This cross-sectional study enrolled all infants born at 24 +0 to 31 +6 weeks and admitted to 57 NICUs of the Chinese Neonatal Network from January 1st, 2019 to December 30th, 2019. The ACS administration was defined as at least one dose of dexamethasone and betamethasone given before delivery. Multiple logistic regressions were applied to determine the association between perinatal factors and ACS usage.
RESULTS:A total of 7828 infants were enrolled, among which 6103 (78.0%) infants received ACS. ACS use rates increased with increasing gestational age (GA), from 177/259 (68.3%) at 24 to 25 weeks' gestation to 3120/3960 (78.8%) at 30 to 31 weeks' gestation. Among infants exposed to ACS, 2999 of 6103 (49.1%) infants received a single complete course, and 33.4% (2039/6103) infants received a partial course. ACS use rates varied from 30.2% to 100% among different hospitals. Multivariate regression showed that increasing GA, born in hospital (inborn), increasing maternal age, maternal hypertension and premature rupture of membranes were associated with higher likelihood to receive ACS.
CONCLUSIONS:The use rate of ACS remained low for infants at 24 to 31 weeks' gestation admitted to Chinese NICUs, with fewer infants receiving a complete course. The use rates varied significantly among different hospitals. Efforts are urgently needed to propose improvement measures and thus improve the usage of ACS.
