Factors associated with the use of prenatal corticosteroids in the management of preterm delivery in Chinese hospitals.

OBJECTIVE: To assess the prevalence of the use of prenatal corticosteroids (PCS) in the management of preterm delivery and the factors associated with PCS administration. METHODS: A secondary analysis was performed of a cross-sectional study conducted in 21 Chinese healthcare facilities between November 2010 and January 2011. The medical records of women who delivered preterm were reviewed. Associations between PCS administration and individual and organizational-level factors were determined. RESULTS: The study population comprised 659 women who delivered at 20 facilities. PCS were given to 158 (68.1%) of 232 women delivering after 27-34 weeks of pregnancy and 119 (27.9%) of 427 delivering after 35-36 weeks. Teenaged girls were less likely to receive PCS after 27-34 weeks than were women aged 20-35 years (odds ratio [OR] 0.22; 95% confidence interval [CI] 0.07-0.70). Among women who delivered after 35-36 weeks, the odds of receiving PCS were lower in urban hospitals than in periurban or rural hospitals (OR 0.04; 95% CI 0.00-0.44), and there was significant hospital-level variance with regard to the administration of PCS (P<0.05). CONCLUSION: Generally, PCS were underprescribed to women at risk of preterm delivery and many women received the treatment after 35-36 weeks of pregnancy, when it might not have been effective.

[A case-control mortality study of migrant pregnant women in Zhejiang province].

OBJECTIVE: To explore the mortality factors of migrant pregnant women and learn the healthcare utilization status to provide efficient interventions. METHODS: A case-control study was conducted in Zhejiang province with a case-control ratio of 1: 4. Cases included migrant pregnant women who died. And controls were migrant pregnant women who survived and matched with single birth, age, hospital and gestational weeks. A questionnaire was used to survey social and demographic factors, healthcare status during antenatal or postpartum period and delivery conditions, etc. RESULTS: Seventy-two cases and 288 controls were recruited. There were significant differences in socio-demographic, antenatal care and obstetric complications between two groups (P < 0.05). No prenatal examination was an important factor affecting maternal mortality by multivariate conditional Logistic regression. CONCLUSION: Prenatal examination is an important influencing factor of maternal mortality. And improving the ability of utilizing health care system is an efficient method of lowering the migrant maternal mortality.