Antenatal corticosteroid administration in women undergoing tocolytic treatment who delivered before 34 weeks of gestation: a retrospective cohort study using a national inpatient database.
Adolescent
Adult
Databases, Factual
Female
Glucocorticoids
/ therapeutic use
Humans
Japan
Logistic Models
Multivariate Analysis
Practice Guidelines as Topic
Practice Patterns, Physicians'
/ statistics & numerical data
Pregnancy
Premature Birth
/ prevention & control
Retrospective Studies
Ritodrine
/ therapeutic use
Time Factors
Tocolysis
Tocolytic Agents
/ therapeutic use
Young Adult
Betamethasone
Dexamethasone
Preterm birth
Ritodrine
Tocolysis
Journal
BMC pregnancy and childbirth
ISSN: 1471-2393
Titre abrégé: BMC Pregnancy Childbirth
Pays: England
ID NLM: 100967799
Informations de publication
Date de publication:
09 Jan 2019
09 Jan 2019
Historique:
received:
04
08
2018
accepted:
02
01
2019
entrez:
11
1
2019
pubmed:
11
1
2019
medline:
7
5
2019
Statut:
epublish
Résumé
Antenatal corticosteroid treatment is globally recommended for women at risk of giving birth before 34 weeks of gestation. In Japan, data on the rate of completing recommended antenatal corticosteroid treatment are lacking. This study aimed to: (i) determine the proportion of patients treated for threatened preterm birth with tocolysis who received antenatal glucocorticoids; and (ii) analyze the association between long-term tocolysis and antenatal glucocorticoids treatment as recommended. This was a retrospective cohort study using a national inpatient database in Japan. We selected pregnant women who had undergone treatment in hospitals due to threatened preterm birth and received the tocolytic ritodrine hydrochloride by infusion from July 2010 to March 2016, and delivered at < 34 weeks of gestation. The primary outcome was receiving of antenatal glucocorticoid treatment as recommended. Multivariable logistic regression was performed to evaluate factors associated with receiving antenatal glucocorticoid treatment. Only 23% of 4048 eligible patients received glucocorticoid treatment as recommended. Those with longer durations of ritodrine hydrochloride infusion were significantly less likely to receive glucocorticoid treatment as recommended. In Japan, many patients who receive tocolytic treatment for threatened preterm birth do not receive antenatal glucocorticoid treatment as recommended. Recommended treatment based on apparent evidences should be performed for the patients with threatened preterm birth.
Sections du résumé
BACKGROUND
BACKGROUND
Antenatal corticosteroid treatment is globally recommended for women at risk of giving birth before 34 weeks of gestation. In Japan, data on the rate of completing recommended antenatal corticosteroid treatment are lacking. This study aimed to: (i) determine the proportion of patients treated for threatened preterm birth with tocolysis who received antenatal glucocorticoids; and (ii) analyze the association between long-term tocolysis and antenatal glucocorticoids treatment as recommended.
METHODS
METHODS
This was a retrospective cohort study using a national inpatient database in Japan. We selected pregnant women who had undergone treatment in hospitals due to threatened preterm birth and received the tocolytic ritodrine hydrochloride by infusion from July 2010 to March 2016, and delivered at < 34 weeks of gestation. The primary outcome was receiving of antenatal glucocorticoid treatment as recommended. Multivariable logistic regression was performed to evaluate factors associated with receiving antenatal glucocorticoid treatment.
RESULTS
RESULTS
Only 23% of 4048 eligible patients received glucocorticoid treatment as recommended. Those with longer durations of ritodrine hydrochloride infusion were significantly less likely to receive glucocorticoid treatment as recommended.
CONCLUSIONS
CONCLUSIONS
In Japan, many patients who receive tocolytic treatment for threatened preterm birth do not receive antenatal glucocorticoid treatment as recommended. Recommended treatment based on apparent evidences should be performed for the patients with threatened preterm birth.
Identifiants
pubmed: 30626359
doi: 10.1186/s12884-019-2174-1
pii: 10.1186/s12884-019-2174-1
pmc: PMC6327534
doi:
Substances chimiques
Glucocorticoids
0
Tocolytic Agents
0
Ritodrine
I0Q6O6740J
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
17Subventions
Organisme : Ministry of Health, Labour and Welfare
ID : H29-Policy-Designated-009
Organisme : Ministry of Health, Labour and Welfare
ID : H29-ICT-General-004
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