Use of antenatal corticosteroids in Brazil: data analysis from the National Survey Nascer no Brasil

ABSTRACT Objective: To estimate the rate of the use of antenatal corticosteroids (ANC) among pregnant women and to identify the conditions associated with their non-use in Brazil. Methods: Secondary data analysis from “Birth in Brazil”, a national hospital-based survey carried out in 2011–2012 on...

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Main Authors: Antônio José Ledo Alves da Cunha, Karina Bilda de Castro Rezende, Maria Elisabeth Lopes Moreira, Silvana Granado Nogueira da Gama, Maria do Carmo Leal
Format: Article
Language:English
Published: Sociedade de Pediatria de São Paulo 2021-09-01
Series:Revista Paulista de Pediatria
Subjects:
Online Access:http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0103-05822022000100407&tlng=pt
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author Antônio José Ledo Alves da Cunha
Karina Bilda de Castro Rezende
Maria Elisabeth Lopes Moreira
Silvana Granado Nogueira da Gama
Maria do Carmo Leal
author_facet Antônio José Ledo Alves da Cunha
Karina Bilda de Castro Rezende
Maria Elisabeth Lopes Moreira
Silvana Granado Nogueira da Gama
Maria do Carmo Leal
author_sort Antônio José Ledo Alves da Cunha
collection DOAJ
description ABSTRACT Objective: To estimate the rate of the use of antenatal corticosteroids (ANC) among pregnant women and to identify the conditions associated with their non-use in Brazil. Methods: Secondary data analysis from “Birth in Brazil”, a national hospital-based survey carried out in 2011–2012 on childbirth and birth. The sample was characterized regarding maternal age, marital status and maternal education, parity, mode of delivery and place of residence. The association of ANC use with gestational age and type of delivery was analyzed. The studied maternal complications were the presence of hypertension, pre-eclampsia/eclampsia, and pyelonephritis, infection by the HIV virus or acquired immune deficiency syndrome. Results: 2,623 pregnant women with less than 37 weeks of gestational age were identified, and, of these, 835 (31.8%) received ANC. The frequency of ANC use was higher among women with gestational ages between 26–34 weeks (481 cases; 48.73%). In pregnancies with less than 37 weeks, the use of ANC was 23.9% in spontaneous deliveries, 20.6% in induced deliveries and 43.8% among those who did not go into labor. The variables vaginal delivery (OR 2.5; 95%CI 1.8–3.4) and living in the countryside were associated with not using ANC, and the occurrence of pre-eclampsia/eclampsia (OR 1.8; 95%CI 1.2–2.9) was associated with the use of ANC. Conclusions: The use of ANC among Brazilian pregnant women was low. Interventions to increase its use are necessary and can contribute to reduce neonatal mortality and morbidity. ANC should be promoted in pregnancies of less than 37 weeks, especially in cases of vaginal delivery and for those living in the countryside.
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spelling doaj.art-4efcb5744fef4aa5ae61d840b574660e2022-12-21T23:28:29ZengSociedade de Pediatria de São PauloRevista Paulista de Pediatria1984-04622021-09-014010.1590/1984-0462/2022/40/2020126Use of antenatal corticosteroids in Brazil: data analysis from the National Survey Nascer no BrasilAntônio José Ledo Alves da Cunhahttps://orcid.org/0000-0003-3592-1849Karina Bilda de Castro Rezendehttps://orcid.org/0000-0003-2086-2620Maria Elisabeth Lopes Moreirahttps://orcid.org/0000-0002-2034-0294Silvana Granado Nogueira da Gamahttps://orcid.org/0000-0002-9200-0387Maria do Carmo Lealhttps://orcid.org/0000-0002-3047-515XABSTRACT Objective: To estimate the rate of the use of antenatal corticosteroids (ANC) among pregnant women and to identify the conditions associated with their non-use in Brazil. Methods: Secondary data analysis from “Birth in Brazil”, a national hospital-based survey carried out in 2011–2012 on childbirth and birth. The sample was characterized regarding maternal age, marital status and maternal education, parity, mode of delivery and place of residence. The association of ANC use with gestational age and type of delivery was analyzed. The studied maternal complications were the presence of hypertension, pre-eclampsia/eclampsia, and pyelonephritis, infection by the HIV virus or acquired immune deficiency syndrome. Results: 2,623 pregnant women with less than 37 weeks of gestational age were identified, and, of these, 835 (31.8%) received ANC. The frequency of ANC use was higher among women with gestational ages between 26–34 weeks (481 cases; 48.73%). In pregnancies with less than 37 weeks, the use of ANC was 23.9% in spontaneous deliveries, 20.6% in induced deliveries and 43.8% among those who did not go into labor. The variables vaginal delivery (OR 2.5; 95%CI 1.8–3.4) and living in the countryside were associated with not using ANC, and the occurrence of pre-eclampsia/eclampsia (OR 1.8; 95%CI 1.2–2.9) was associated with the use of ANC. Conclusions: The use of ANC among Brazilian pregnant women was low. Interventions to increase its use are necessary and can contribute to reduce neonatal mortality and morbidity. ANC should be promoted in pregnancies of less than 37 weeks, especially in cases of vaginal delivery and for those living in the countryside.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0103-05822022000100407&tlng=ptAdrenal cortex hormonesPrenatal careObstetric labor, prematurePrimary preventionRisk factors
spellingShingle Antônio José Ledo Alves da Cunha
Karina Bilda de Castro Rezende
Maria Elisabeth Lopes Moreira
Silvana Granado Nogueira da Gama
Maria do Carmo Leal
Use of antenatal corticosteroids in Brazil: data analysis from the National Survey Nascer no Brasil
Revista Paulista de Pediatria
Adrenal cortex hormones
Prenatal care
Obstetric labor, premature
Primary prevention
Risk factors
title Use of antenatal corticosteroids in Brazil: data analysis from the National Survey Nascer no Brasil
title_full Use of antenatal corticosteroids in Brazil: data analysis from the National Survey Nascer no Brasil
title_fullStr Use of antenatal corticosteroids in Brazil: data analysis from the National Survey Nascer no Brasil
title_full_unstemmed Use of antenatal corticosteroids in Brazil: data analysis from the National Survey Nascer no Brasil
title_short Use of antenatal corticosteroids in Brazil: data analysis from the National Survey Nascer no Brasil
title_sort use of antenatal corticosteroids in brazil data analysis from the national survey nascer no brasil
topic Adrenal cortex hormones
Prenatal care
Obstetric labor, premature
Primary prevention
Risk factors
url http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0103-05822022000100407&tlng=pt
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