J Clin Gynecol Obstet
Journal of Clinical Gynecology and Obstetrics, ISSN 1927-1271 print, 1927-128X online, Open Access
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Letter to the Editor

Volume 3, Number 2, May 2014, pages 80-80


Antenatal Corticosteroid Administration at a Japanese Hospital

Shunji Suzuki

Department of Obstetrics and Gynecology, Japanese Red Cross Katsushika Maternity Hospital, 5-11-12 Tateishi, Katsushika-ku, Tokyo 124-0012, Japan

Manuscript accepted for publication May 8, 2014
Short title: Antenatal Corticosteroid Administration
doi: https://doi.org/10.14740/jcgo252w

To the Editor▴Top 

According to a report concerning the antenatal corticosteroid (ACS) administration rate among eligible patients who delivered from 24 - 34 weeks of gestation at a tertiary center in the United States in 2014, 81.3% of them received at least 1 dose of ACS [1]. This rate may be higher than the average ACS administration rate in Japan (about 51% in 2011) [2].

For example, in my institution, one of the major perinatal centers in Tokyo, Japan, only 60 in 135 patients (44%) who delivered from 24 - 32 weeks of gestation received at least 1 dose of ACS in 2008 - 2010. The difference in the ACS administration rates between Japan and the United States may be due to the differences in the perinatal care system. In Japan, about half of all pregnancies and deliveries are managed at private clinics without neonatologists; patients with a risk of preterm birth managed at private clinics need to be transported to perinatal centers. There may be some cases of delayed transport leading to a decreased time period for ACS administration at perinatal centers. In my institution, the ACS administration rate (27%: 21 in 79 cases) in cases following transport from private clinics was significantly lower than that in those managed in-house (70%: 39 in 56 cases, odds ratio 0.16, 95% confidence interval 0.07 - 0.34, P < 0.01 by the Chi-square test).

Therefore, in Japan the early transport of patients at risk of preterm delivery from private clinics to perinatal centers may improve the ACS administration rate.


References▴Top 
  1. Chandrasekaran S, Srinivas SK. Antenatal corticosteroid administration: understanding its use as an obstetric quality metric. Am J Obstet Gynecol. 2014;210(2):143 e141-147.
    pubmed
  2. Neonatal Research Network Database in Japan. Network data. http://plaza.umin.ac.jp/nrndata/indexe.htm.


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Journal of Clinical Gynecology and Obstetrics, quarterly, ISSN 1927-1271 (print), 1927-128X (online), published by Elmer Press Inc.                     
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