Disparities in the use of antenatal corticosteroids among women with hypertension in North Carolina

J Perinatol. 2020 Mar;40(3):456-462. doi: 10.1038/s41372-019-0555-y. Epub 2019 Nov 25.

Abstract

Objective: To evaluate antenatal corticosteroids (ANS) use in pregnant women with hypertension.

Study design: Retrospective analysis of ANS use in the Perinatal Quality Collaborative of North Carolina between 2015 and 2017.

Results: Twenty-five centers participated, with 9% (1580/17,692) of mothers delivering at <34 weeks; of these, 81% (1286/1580) received a full course of ANS, which was not different between phases (p = 0.32), or between Level III/IV neonatal intensive care units (NICUs; 82%), and I/II NICUs (76%) (p = 0.05). In Level III/IV NICUs, White mothers were more likely to receive ANS (87%) than African Americans (77%) or other race/ethnicity (80%) (including Hispanics) (p = 0.001). ANS use did not differ among mothers with different payers (p = 0.94).

Conclusion: The rates of full ANS courses did not significantly increase from 2015-2017 and disparities persisted. Targeted efforts to improve ANS exposures among hypertensive African American and Hispanic mothers, as well as in community hospital settings are needed.

Publication types

  • Multicenter Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adrenal Cortex Hormones / therapeutic use*
  • Black or African American
  • Female
  • Healthcare Disparities / ethnology*
  • Hispanic or Latino
  • Humans
  • Infant, Premature, Diseases / prevention & control*
  • North Carolina
  • Pre-Eclampsia / ethnology*
  • Pregnancy
  • Premature Birth / ethnology
  • Prenatal Care*
  • Quality Improvement*
  • Retrospective Studies
  • White People

Substances

  • Adrenal Cortex Hormones