Antenatal corticosteroids for early preterm birth: implementation strategy lessons from the WHO ACTION-I trial.
Health Res Policy Syst
; 20(1): 141, 2022 Dec 28.
Article
em En
| MEDLINE
| ID: mdl-36578090
ABSTRACT
The WHO ACTION-I trial, the largest placebo-controlled trial on antenatal corticosteroids (ACS) efficacy and safety to date, reaffirmed the benefits of ACS on mortality reduction among early preterm newborns in low-income settings. We discuss here lessons learned from ACTION-I trial that are relevant to a strategy for ACS implementation to optimize impact. Key elements included (i) gestational age dating by ultrasound (ii) application of appropriate selection criteria by trained obstetric physicians to identify women with a likelihood of preterm birth for ACS administration; and (iii) provision of a minimum package of care for preterm newborns in facilities. This strategy accurately identified a large proportion of women who eventually gave birth preterm, and resulted in a 16% reduction in neonatal mortality from ACS use. Policy-makers, programme managers and clinicians are encouraged to consider this implementation strategy to effectively scale and harness the benefits of ACS in saving preterm newborn lives.
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Base de dados:
MEDLINE
Assunto principal:
Nascimento Prematuro
Idioma:
En
Ano de publicação:
2022
Tipo de documento:
Article