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Antenatal corticosteroids for early preterm birth: implementation strategy lessons from the WHO ACTION-I trial
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 relevan...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9798686/ https://www.ncbi.nlm.nih.gov/pubmed/36578090 http://dx.doi.org/10.1186/s12961-022-00941-z |
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author | 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 |
author_facet | 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 |
author_sort | De Costa, Ayesha |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-9798686 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-97986862022-12-30 Antenatal corticosteroids for early preterm birth: implementation strategy lessons from the WHO ACTION-I trial 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 Health Res Policy Syst Opinion 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. BioMed Central 2022-12-28 /pmc/articles/PMC9798686/ /pubmed/36578090 http://dx.doi.org/10.1186/s12961-022-00941-z Text en © © World Health Organization 2022 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Opinion 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 Antenatal corticosteroids for early preterm birth: implementation strategy lessons from the WHO ACTION-I trial |
title | Antenatal corticosteroids for early preterm birth: implementation strategy lessons from the WHO ACTION-I trial |
title_full | Antenatal corticosteroids for early preterm birth: implementation strategy lessons from the WHO ACTION-I trial |
title_fullStr | Antenatal corticosteroids for early preterm birth: implementation strategy lessons from the WHO ACTION-I trial |
title_full_unstemmed | Antenatal corticosteroids for early preterm birth: implementation strategy lessons from the WHO ACTION-I trial |
title_short | Antenatal corticosteroids for early preterm birth: implementation strategy lessons from the WHO ACTION-I trial |
title_sort | antenatal corticosteroids for early preterm birth: implementation strategy lessons from the who action-i trial |
topic | Opinion |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9798686/ https://www.ncbi.nlm.nih.gov/pubmed/36578090 http://dx.doi.org/10.1186/s12961-022-00941-z |
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