Use of prenatal corticosteroids for preterm birth in three Latin American countries
Received 19 May 2009; received in revised form 4 August 2009; accepted 10 September 2009. published online 05 November 2009.
Abstract
Objective
To determine the prevalence of the use of prenatal corticosteroids in women who delivered prematurely in 3 Latin American counties and to evaluate the maternal characteristics associated with use.
Methods
A multicenter, prospective, descriptive study was conducted in 4 hospitals in Ecuador, 5 in Uruguay, and 3 in El Salvador between 2004 and 2008. Women who had delivered between 24 and 34weeks of pregnancy responded to a questionnaire assessing sociodemographic characteristics, obstetric history, prenatal care, women's attitudes to health services and knowledge of preterm risk factors, prenatal corticosteroid administration, and characteristics of the delivery and neonate. The association between the prenatal corticosteroid use and the study variables was evaluated through a logistic regression analysis based on a hierarchical model.
Results
A total of 1062 women who had a preterm birth were included in the study. Prenatal corticosteroid use was 34.8% (95% CI, 29.9%–39.9%) in Ecuador, 54.6% (95% CI, 49.6%–59.6%) in El Salvador, and 71.0% (95% CI, 65.3%–76.2%) in Uruguay. Hospital admission-to-delivery time was associated with the use of prenatal corticosteroids in all 3 countries.
Conclusion
The study revealed a varied pattern of use of prenatal corticosteroids across the 3 countries, and a diversity of influencing factors.
aDepartment of Preventive Medicine, School of Medicine, University of Uruguay, Clinical and Epidemiological Research Unit Montevideo, Uruguay
bInstitute for Clinical Effectiveness and Health Policy, Buenos Aires, Argentina
cSchool of Medical Sciences, University of Cuenca, Ecuador
dSchool of Medicine, Evangelic University of El Salvador, El Salvador
Corresponding author. Institute for Clinical Effectiveness and Health Policy (IECS), Buenos Aires, Argentina. Tel.: +54 11 49534058 int 18; fax: +54 11 49534058 int 27.
ABSTRACT