title: Factors associated with the use of prenatal corticosteroids in the management of preterm delivery in Chinese hospitals.
abstract: OBJECTIVE
  To assess the prevalence of the use of prenatal corticosteroids (PCS) in the management of preterm delivery and the factors associated with PCS administration.
  
  
  METHODS
  A secondary analysis was performed of a cross-sectional study conducted in 21 Chinese healthcare facilities between November 2010 and January 2011. The medical records of women who delivered preterm were reviewed. Associations between PCS administration and individual and organizational-level factors were determined.
  
  
  RESULTS
  The study population comprised 659 women who delivered at 20 facilities. PCS were given to 158 (68.1%) of 232 women delivering after 27-34 weeks of pregnancy and 119 (27.9%) of 427 delivering after 35-36 weeks. Teenaged girls were less likely to receive PCS after 27-34 weeks than were women aged 20-35 years (odds ratio [OR] 0.22; 95% confidence interval [CI] 0.07-0.70). Among women who delivered after 35-36 weeks, the odds of receiving PCS were lower in urban hospitals than in periurban or rural hospitals (OR 0.04; 95% CI 0.00-0.44), and there was significant hospital-level variance with regard to the administration of PCS (P<0.05).
  
  
  CONCLUSIONS
  Generally, PCS were underprescribed to women at risk of preterm delivery and many women received the treatment after 35-36 weeks of pregnancy, when it might not have been effective.
authors.affiliation: Department of Child, Adolescent and Women's Health, Peking University, Beijing, China; Key Laboratory of Reproductive Health, Ministry of Health, Beijing, China.
authors.forename: Xi
authors.initials: X
authors.lastname: Wang
authors.affiliation: School of Population Health, University of Western Australia, Perth, WA, Australia; Department of Reproductive Health and Research, World Health Organization, Geneva, Switzerland.
authors.forename: Joshua P
authors.initials: JP
authors.lastname: Vogel
authors.affiliation: Department of Child, Adolescent and Women's Health, Peking University, Beijing, China; Key Laboratory of Reproductive Health, Ministry of Health, Beijing, China.
authors.forename: Chu-yun
authors.initials: CY
authors.lastname: Kang
authors.affiliation: Department of Child, Adolescent and Women's Health, Peking University, Beijing, China; Key Laboratory of Reproductive Health, Ministry of Health, Beijing, China.
authors.forename: Yan-qiu
authors.initials: YQ
authors.lastname: Gao
authors.affiliation: Department of Child, Adolescent and Women's Health, Peking University, Beijing, China; Key Laboratory of Reproductive Health, Ministry of Health, Beijing, China.
authors.forename: Deng
authors.initials: D
authors.lastname: Ao
authors.affiliation: Department of Child, Adolescent and Women's Health, Peking University, Beijing, China; Key Laboratory of Reproductive Health, Ministry of Health, Beijing, China.
authors.forename: Ru-yan
authors.initials: RY
authors.lastname: Pang
authors.affiliation: Department of Child, Adolescent and Women's Health, Peking University, Beijing, China; Key Laboratory of Reproductive Health, Ministry of Health, Beijing, China. Electronic address: wangyan@bjmu.edu.cn.
authors.forename: Yan
authors.initials: Y
authors.lastname: Wang
mesh_terms: D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage*; D000328:Adult; D000367:Age Factors; D002681:China / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D005865:Gestational Age; D006780:Hospitals, Rural / Q000706:statistics & numerical data; D006786:Hospitals, Urban / Q000706:statistics & numerical data; D006801:Humans; D007231:Infant, Newborn; D016017:Odds Ratio; D011247:Pregnancy; D047928:Premature Birth / Q000188:drug therapy* / Q000453:epidemiology; D015995:Prevalence; D055815:Young Adult
chemical_list: D000305:Adrenal Cortex Hormones
keywords: China; Multilevel analysis; Prenatal corticosteroids; Preterm birth