Factors Associated with Antenatal Steroid Uptake in Mothers at Risk of Preterm Birth at a Teaching Hospital In Ghana

Abstract

Background: This study was performed to determine the factors associated with antenatal corticosteroid (ACS) use in pregnant women at risk of preterm birth at the Korle-Bu Teaching hospital (KBTH) in Accra.
Method: A descriptive cross-sectional study. 
Subjects and outcome measures - Mothers who should have received antenatal steroids were identified by the admission of their preterm infants to the neonatal unit at KBTH. Maternal ACS status was determined, and the characteristics of women who received ACS were compared with those who did not.
Results: There were 284 eligible admissions during the study period of 6 months, of which 43% (121 mothers) were studied due to administrative and logistical constraints. Out of these 121 mothers, 92 (76%) had received antenatal corticosteroids. Mothers with
primary and secondary education were less likely to receive antenatal corticosteroid (OR 0.240, 95% CI 0.058-0.984), (OR 0.211, 95% CI 0.050-0.897) respectively, compared to those with tertiary level education. Mothers who delivered at other hospitals outside KBTH were also less likely to receive ACS (OR 0.195, 95% CI 0.070-0.545). Women who had caesarean delivery were more likely to receive
antenatal corticosteroid compared to those with vaginal delivery (OR 4.378 95% CI 1.690-11.346). In this cohort, there was no association between antenatal corticosteroid use and maternal age, maternal medical condition, fetal gender or previous preterm delivery.
Conclusion: ACS use in KBTH is low but similar to other low-income countries. Low educational attainment and delivery outside the tertiary facility are factors associated with low use of ACS.