title: [Assessment of quality of obstetric hospital care: use of corticoid in preterm labor].
abstract: This study aimed to assess quality of obstetric care for preterm labor patients, using referents, indicators, and standards derived from scientific evidence, focusing on antenatal corticotherapy. Available meta-analyses and randomized controlled trials were examined to establish referents, defining indicators and estimating process and outcome standards for the present study. Data from hospital discharge summaries of seven public maternity hospitals in Rio de Janeiro were analyzed. The standard of process used was 100%. It was not possible to estimate outcome standards, since the necessary adjustment for gestational age was not feasible. Utilization of antenatal corticotherapy in the present study was very low, about 4% and 2%, considering patients up to 33 weeks and 6 days and 36 weeks and 6 days, respectively. Failure to use antenatal corticotherapy when formally indicated deserves attention by health planners and managers, considering: a) the ease in incorporating such a technology, in contrast to the adequate incorporation of special/intensive neonatal care; b) benefits and costs associated with this technology compared to those of delivering neonatal care to premature babies.
authors.affiliation: Centro de Avaliação de Programas, Serviços e Tecnologias de Saúde, Escola Nacional de Saúde Pública, Fundação Oswaldo Cruz, Rua Leopoldo Bulhões 1480, sala 708, Rio de Janeiro, RJ 21045-900, Brasil.
authors.forename: L K
authors.initials: LK
authors.lastname: Silva
authors.forename: T P
authors.initials: TP
authors.lastname: Costa
authors.forename: A F
authors.initials: AF
authors.lastname: Reis
authors.forename: N O
authors.initials: NO
authors.lastname: Iamada
authors.forename: A P
authors.initials: AP
authors.lastname: Azevedo
authors.forename: C P
authors.initials: CP
authors.lastname: Albuquerque
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D005260:Female; D005865:Gestational Age; D006779:Hospitals, Public / Q000592:standards; D006801:Humans; D015994:Incidence; D007226:Infant Mortality; D007231:Infant, Newborn; D007752:Obstetric Labor, Premature / Q000188:drug therapy*; D009774:Obstetrics; D010043:Outcome and Process Assessment, Health Care; D011247:Pregnancy; D012127:Respiratory Distress Syndrome, Newborn / Q000188:drug therapy / Q000453:epidemiology
chemical_list: D000305:Adrenal Cortex Hormones