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- Title
Antenatal corticosteroids for early preterm birth: implementation strategy lessons from the WHO ACTION-I trial.
- Authors
De Costa, Ayesha; Oladapo, Olufemi T.; Gupta, Shuchita; Portela, Anayda; Vogel, Joshua P.; Souza, Joao Paulo; Rao, Suman; Minckas, Nicole; Tuncalp, Özge; Bahl, Rajiv; Althabe, Fernando
- 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.
- Subjects
PREMATURE labor; WOMEN physicians; NEONATAL mortality; CORTICOSTEROIDS; GESTATIONAL age; NEWBORN infants
- Publication
Health Research Policy & Systems, 2022, Vol 20, Issue 1, p1
- ISSN
1478-4505
- Publication type
Article
- DOI
10.1186/s12961-022-00941-z