Audit of antenatal steroid use in mothers of preterms admitted to a neonatal intensive care unit in Ghana

Ghana Med J. 2018 Mar;52(1):3-7. doi: 10.4314/gmj.v52i1.2.

Abstract

Background: Antenatal corticosteroids (ACS) are established as an effective method of reducing preterm morbidity and mortality. At the Korle Bu Teaching Hospital (KBTH), a tertiary referral centre in Ghana, it is recommended that a course of ACS should be given to mothers before delivery between 24 weeks to 34 weeks gestation.

Objectives: The study was performed primarily to determine the level of adherence to guidelines on administration of ACS.

Methods: All babies with gestational ages up to 34 weeks admitted to the neonatal unit (NICU) during the period of the study were eligible for inclusion.

Results: There were 214 eligible admissions during the study period, of which 93 babies (43%) were studied due to poor access to medical records. Dexamethasone was the only steroid used, and mothers of 65 (70%) of the 93 babies received at least one dose; 17 (18%) received only one dose, 35 (38%) - 2 doses, 9 (10%) - 3 doses, and 4 (4%) - 4 doses.

Conclusions: This study has shown a low uptake of antenatal corticosteroids, similar to other low-income and middle-income countries. To improve preterm survival and morbidity, there is an urgent need to increase the use of corticosteroids before preterm deliveries in Ghana and other low-income and middle-income countries.

Funding: Not indicated.

Keywords: Antenatal corticosteroids; audit; low-income countries; neonatal intensive care; prematurity.

MeSH terms

  • Adolescent
  • Adrenal Cortex Hormones / administration & dosage*
  • Adult
  • Developing Countries
  • Dexamethasone / administration & dosage
  • Dose-Response Relationship, Drug
  • Drug Administration Schedule
  • Female
  • Gestational Age
  • Ghana
  • Guideline Adherence
  • Humans
  • Infant, Newborn
  • Intensive Care Units, Neonatal / organization & administration
  • Medical Audit*
  • Pregnancy
  • Premature Birth*
  • Prenatal Care*
  • Young Adult

Substances

  • Adrenal Cortex Hormones
  • Dexamethasone