Antenatal corticosteroids (ANCS) have been shown to reduce the risk of serious health problems and death among preterm infants. While rates of administration are generally high, evidence suggests that ANCS administration rates can and should be optimized to reach more than 90% of eligible pregnant women as a way to improve outcomes for babies born too soon.

OPQC’s Antenatal Corticosteroids Project aimed to increase the percent of women between 24 0/7 weeks and 33 6/7 weeks who receive any ANCS prior to delivery. Nineteen OPQC OB charter hospitals participated in the project. Hand-collected and Ohio Integrated Perinatal Health Information System (IPHIS or the birth registry) data were used to track progress. Review of hospital medical records showed rates of ANCS administration consistently >90% and, as of December 2014, based on birth registry data, 86% of births 24 0/7 to 33 6/7 weeks gestation received ANCS, approaching our goal of 90%. These results indicate that not only are ANCS administration rates high, but they are reflected in Ohio's largest perinatal data base, the birth registry. The current level of ANCS use can best be monitored and sustained by improving the quality and timeliness of Ohio birth registry data documenting ANCS administration for women who deliver between 24 0/7 and 33 6/7 weeks.

OPQC has developed a toolkit, “Optimizing Antenatal Use of Steroids to Improve Outcomes for Preterm Infants,” to share lessons learned and describe quality improvement interventions to promote reliable systems for appropriate administration of ANCS. This toolkit includes tools for:

• ANCS administration

• Establishing an ANCS documentation system

• Improving the identification of eligible mothers

• Creating a “High Reliability” culture to optimize ANCS administration

Please contact info@opqc.net if you have any questions.

Resources

ANCS Toolkit: "Optimizing Antenatal Use of Steroids to Improve Outcomes for Preterm Infants"

Publications

Kaplan HC, Sherman SN, Cleveland C, Goldenhar LM, Lannon CM, Bailit JL. (2016). Reliable implementation of evidence: a qualitative study of antenatal corticosteroid administration in Ohio hospitals. BMJ Quality & Safety, Mar;25(3):173-81. doi: 10.1136/bmjqs-2015-003984. Epub 2015 Jun 8. PMID: 26056321