Association between antenatal corticosteroid use and perinatal mortality among preterm births in hospitals in Tanzania.

<h4>Objectives</h4>The primary aims of this study were to investigate if exposure to antenatal corticosteroids (ACS) was associated with lower rates of perinatal mortality (primary outcome) and other adverse perinatal outcomes (i.e., stillbirth, early neonatal mortality, APGAR score of &...

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Autores principales:	Stanley Mwita, Eveline Konje, Benjamin Kamala, Angelina Izina, Semvua Kilonzo, Andrew Kigombola, Karol J Marwa, Mary Jande, Deborah Dewey
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/0ad9c4f662794990bc7f79f196765e07
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spelling	oai:doaj.org-article:0ad9c4f662794990bc7f79f196765e072021-12-02T20:06:34ZAssociation between antenatal corticosteroid use and perinatal mortality among preterm births in hospitals in Tanzania.1932-620310.1371/journal.pone.0254916https://doaj.org/article/0ad9c4f662794990bc7f79f196765e072021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0254916https://doaj.org/toc/1932-6203<h4>Objectives</h4>The primary aims of this study were to investigate if exposure to antenatal corticosteroids (ACS) was associated with lower rates of perinatal mortality (primary outcome) and other adverse perinatal outcomes (i.e., stillbirth, early neonatal mortality, APGAR score of < 7 at 5 mins, neonatal sepsis and respiratory distress syndrome) in preterm infants in hospitals in Tanzania. We also examine factors associated with administration of ACS among women at risk of preterm delivery.<h4>Methods</h4>A hospital-based prospective chart review study was undertaken in four hospitals located in Nyamagana and Sengerema districts, Tanzania. The study population included all stillborn and live born preterm infants delivered between 24 to 34 weeks of gestation between July 2019 to February 2020. A total 1125 preterm infants were delivered by 1008 women (895 singletons, 230 multiple). Sociodemographic and medical data were recorded from participants' medical records.<h4>Results</h4>Three hundred and fifty-six (35.3%) women were administered at least one dose of ACS between 24 to 34 weeks' gestation and 385 (34.2%) infants were exposed to ACS. Infants exposed to ACS had a lower rate of perinatal mortality (13.77%) compared to those who were not exposed (28.38%). Multivariate analysis indicated that infants exposed to ACS were less likely to die during perinatal period, aRR 0.34 (95%CI 0.26-0.44). Only one-third of the sample was provided with ACS. Administration of ACS was associated with maternal education, attending antenatal care more than 3 times, method used to assess gestational age, maternal infection, exposure to maternal antibiotics, delivery mode and level of health facility.<h4>Conclusion</h4>ACS significantly reduced the risk in perinatal mortality among infants born preterm in a limited resource setting. However, only about one-third of eligible women were provided with ACS, indicating low usage of ACS. Numerous factors were associated with low usage of ACS in this setting.Stanley MwitaEveline KonjeBenjamin KamalaAngelina IzinaSemvua KilonzoAndrew KigombolaKarol J MarwaMary JandeDeborah DeweyPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 7, p e0254916 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Stanley Mwita Eveline Konje Benjamin Kamala Angelina Izina Semvua Kilonzo Andrew Kigombola Karol J Marwa Mary Jande Deborah Dewey Association between antenatal corticosteroid use and perinatal mortality among preterm births in hospitals in Tanzania.
description	<h4>Objectives</h4>The primary aims of this study were to investigate if exposure to antenatal corticosteroids (ACS) was associated with lower rates of perinatal mortality (primary outcome) and other adverse perinatal outcomes (i.e., stillbirth, early neonatal mortality, APGAR score of < 7 at 5 mins, neonatal sepsis and respiratory distress syndrome) in preterm infants in hospitals in Tanzania. We also examine factors associated with administration of ACS among women at risk of preterm delivery.<h4>Methods</h4>A hospital-based prospective chart review study was undertaken in four hospitals located in Nyamagana and Sengerema districts, Tanzania. The study population included all stillborn and live born preterm infants delivered between 24 to 34 weeks of gestation between July 2019 to February 2020. A total 1125 preterm infants were delivered by 1008 women (895 singletons, 230 multiple). Sociodemographic and medical data were recorded from participants' medical records.<h4>Results</h4>Three hundred and fifty-six (35.3%) women were administered at least one dose of ACS between 24 to 34 weeks' gestation and 385 (34.2%) infants were exposed to ACS. Infants exposed to ACS had a lower rate of perinatal mortality (13.77%) compared to those who were not exposed (28.38%). Multivariate analysis indicated that infants exposed to ACS were less likely to die during perinatal period, aRR 0.34 (95%CI 0.26-0.44). Only one-third of the sample was provided with ACS. Administration of ACS was associated with maternal education, attending antenatal care more than 3 times, method used to assess gestational age, maternal infection, exposure to maternal antibiotics, delivery mode and level of health facility.<h4>Conclusion</h4>ACS significantly reduced the risk in perinatal mortality among infants born preterm in a limited resource setting. However, only about one-third of eligible women were provided with ACS, indicating low usage of ACS. Numerous factors were associated with low usage of ACS in this setting.
format	article
author	Stanley Mwita Eveline Konje Benjamin Kamala Angelina Izina Semvua Kilonzo Andrew Kigombola Karol J Marwa Mary Jande Deborah Dewey
author_facet	Stanley Mwita Eveline Konje Benjamin Kamala Angelina Izina Semvua Kilonzo Andrew Kigombola Karol J Marwa Mary Jande Deborah Dewey
author_sort	Stanley Mwita
title	Association between antenatal corticosteroid use and perinatal mortality among preterm births in hospitals in Tanzania.
title_short	Association between antenatal corticosteroid use and perinatal mortality among preterm births in hospitals in Tanzania.
title_full	Association between antenatal corticosteroid use and perinatal mortality among preterm births in hospitals in Tanzania.
title_fullStr	Association between antenatal corticosteroid use and perinatal mortality among preterm births in hospitals in Tanzania.
title_full_unstemmed	Association between antenatal corticosteroid use and perinatal mortality among preterm births in hospitals in Tanzania.
title_sort	association between antenatal corticosteroid use and perinatal mortality among preterm births in hospitals in tanzania.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/0ad9c4f662794990bc7f79f196765e07
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Association between antenatal corticosteroid use and perinatal mortality among preterm births in hospitals in Tanzania.

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