Browsing by Author "Althabe, Fernando"

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Use of antenatal corticosteroids for preterm birth in Latin America: providers knowledge, attitudes and practices
(2013) Alemán Riganti, Alicia; Cafferata, María Luisa; Gibbons, Luz; Althabe, Fernando; Ortiz, José; Sandoval, Xochitl; Padilla Raygoza, Nicolás; Belizán, José M.
Background Antenatal corticosteroids administered to women at risk of preterm birth is an intervention which has been proved to reduce the risk of respiratory distress syndrome, intraventricular hemorrhage, and neonatal mortality. There is a significant gap in the literature regarding the prevalence of the use of antenatal corticosteroids in Latin American countries and the attitudes and opinions of providers regarding this practice. The aim of this study was to assess the knowledge, attitudes and practices of health care providers regarding the use of antenatal corticosteroids in women at risk of preterm birth in Latin America. Methods This was a multicenter, prospective, descriptive study conducted in maternity hospitals in Ecuador, El Salvador, Mexico and Uruguay. Physicians and midwives who provide prenatal care or intrapartum care for women delivering in the selected hospitals were approached using a self-administered questionnaire. Descriptive statistics was used. Results The percentage of use of ACT in threatened preterm labour (TPL) reported by providers varies from 70% in Mexico to 97% in Ecuador. However, 60% to 20% of the providers mentioned that they would not use this medication in women at risk and would limit its use when there was a threatened preterm labour. In only one country recommended regimens of antenatal corticosteroids are followed by around 90% of providers whereas in the other three countries recommended regimens are followed by only 21%, 61%, 69% of providers. Around 40% of providers mentioned that they would administer a new dose of corticosteroids again, regardless the patient already receiving an entire regimen. Between 11% and 35% of providers, according to the countries, mentioned that they do not have adequate information on the correct use of this medication. Conclusions This study shows that the use of this intervention could be improved by increasing the knowledge of Latin American providers on its indications, benefits, and regimens.
Use of prenatal corticosteroids for preterm birth in three Latin American countries
(2010) Alemán Riganti, Alicia Valentina; Cafferata, María Luisa; Althabe, Fernando; Gibbons, Luz; Ortiz Segarra, José Ignacio; Sandoval, Xochitl; Belizan, José M.
Objective: To determine the prevalence of the use of prenatal corticosteroids in women who delivered prematurely in 3 Latin American counties and to evaluate the maternal characteristics associated with use. Methods: A multicenter, prospective, descriptive study was conducted in 4 hospitals in Ecuador, 5 in Uruguay, and 3 in El Salvador between 2004 and 2008. Women who had delivered between 24 and 34 weeks of pregnancy responded to a questionnaire assessing sociodemographic characteristics, obstetric history, prenatal care, women's attitudes to health services and knowledge of preterm risk factors, prenatal corticosteroid administration, and characteristics of the delivery and neonate. The association between the prenatal corticosteroid use and the study variables was evaluated through a logistic regression analysis based on a hierarchical model. Results: A total of 1062 women who had a preterm birth were included in the study. Prenatal corticosteroid use was 34.8% (95% CI, 29.9%-39.9%) in Ecuador, 54.6% (95% CI, 49.6%-59.6%) in El Salvador, and 71.0% (95% CI, 65.3%-76.2%) in Uruguay. Hospital admission-to-delivery time was associated with the use of prenatal corticosteroids in all 3 countries. Conclusion: The study revealed a varied pattern of use of prenatal corticosteroids across the 3 countries, and a diversity of influencing factors. © 2009 International Federation of Gynecology and Obstetrics