Related Experiment Video

Updated: Aug 8, 2026

Using a Murine Model of Psychosocial Stress in Pregnancy as a Translationally Relevant Paradigm for Psychiatric Disorders in Mothers and Infants
06:39

Using a Murine Model of Psychosocial Stress in Pregnancy as a Translationally Relevant Paradigm for Psychiatric Disorders in Mothers and Infants

Published on: June 13, 2021

Promoting antenatal steroid use for fetal maturation: results from the California Perinatal Quality Care

David D Wirtschafter1, Beate H Danielsen, Elliott K Main

  • 1California Perinatal Quality Care Collaborative, Palo Alto, California, USA. david.wirtschafter@juno.com

The Journal of Pediatrics
|June 2, 2006
PubMed

Insights

Regional quality improvement collaboratives effectively enhanced antenatal steroid administration rates in preterm infants. This initiative demonstrated significant improvements in perinatal care quality across participating centers.

Area of Science:

  • Perinatal Medicine
  • Quality Improvement Science
  • Public Health Initiatives

Background:

  • The California Perinatal Quality Care Collaborative (CPQCC) was established to improve perinatal care through a multi-institutional database.
  • Quality improvement (QI) initiatives are crucial for identifying and addressing gaps in healthcare delivery.
  • Assessing antenatal steroid administration is a key indicator of effective preterm birth management.

Purpose of the Study:

  • To evaluate the effectiveness of a collaborative QI approach in improving antenatal steroid administration rates.
  • To assess changes in performance metrics for participating perinatal centers.
  • To determine if the number of centers performing below the lowest quartile decreased post-intervention.

Main Methods:

  • A statewide QI cycle targeting antenatal steroid use was implemented from 1998 to 2001.
  • Baseline data from 1998 were evaluated, followed by intervention dissemination.
  • Educational materials and presentations were utilized to promote recommended interventions among 25 participating centers.

Main Results:

  • Antenatal steroid administration increased from 76% (1524 infants) in 1998 to 86% (1475 infants) in 2001 (P < .001).
  • In 2001, 23 out of 25 hospitals surpassed the 1998 lower-quartile performance benchmark of 69.3%.
  • The QI collaborative demonstrated a significant positive impact on a critical aspect of preterm infant care.

Conclusions:

  • Regional collaborations are a highly effective strategy for enhancing the quality of perinatal care.
  • Data-driven QI initiatives can lead to measurable improvements in clinical practice.
  • Sustained efforts in collaborative quality improvement yield significant benefits for patient outcomes.
Abstract

More Related Videos

Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale19:15

Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale

Published on: August 25, 2014

Related Concept Videos

Teratogenicity01:07

Teratogenicity

The ability of a drug to produce structural deformations and functional abnormalities in the developing embryo or the fetus is called teratogenicity, and the drug producing this effect is known as a teratogen. Teratogenic effects include stillbirth, miscarriage, intrauterine growth restriction, and neurocognitive delay. A teratogen may affect the embryo at different stages of development, which is important in determining the type and extent of the damage. During blastocyst formation, the early...
Intrauterine Drug Delivery Systems01:21

Intrauterine Drug Delivery Systems

Controlled-release systems for intravaginal and intrauterine drug delivery have been developed primarily for the administration of contraceptive steroid hormones. These delivery routes circumvent first-pass hepatic metabolism, thereby enhancing bioavailability and allowing for reduced systemic dosages compared to oral administration. Such approaches contribute to improved therapeutic efficacy and patient compliance, particularly in long-term contraceptive regimens.Intravaginal Drug Delivery...
Development of the Oral Microbiota01:28

Development of the Oral Microbiota

The establishment of the oral microbiome begins before birth, challenging the long-held belief that the fetal oral cavity is sterile. The presence of oral microbes such as Streptococcus and Fusobacterium in amniotic fluid suggests that microbial exposure may occur in utero, potentially through translocation from the maternal oral or gastrointestinal tract. This early colonization primes the neonatal immune system and sets the stage for subsequent microbial succession. Maternal health,...
Drug Dosing: Infants and Children01:29

Drug Dosing: Infants and Children

Pediatric patient dosages diverge from adults due to disparities in body surface area, total body water, and extracellular fluid per kilogram of body weight. The dosing regimen considers the variations in pharmacokinetics and pharmacology across distinct age groups, encompassing preterm newborns, infants, young children, older children, and adolescents. Calculation of pediatric patient doses is predicated on determining body surface area, which exhibits a superior correlation with the child's...
Antiasthma Drugs: Inhaled Corticosteroids and Glucocorticoids01:25

Antiasthma Drugs: Inhaled Corticosteroids and Glucocorticoids

Inhaled corticosteroids (ICS) are anti-inflammatory drugs used primarily in treating persistent asthma and providing long-term maintenance. They target the bronchial mucosa, the lining of the airways, to control inflammation, a critical factor in asthma progression and exacerbation.
ICS work through a multifaceted mechanism of action. They suppress the inflammatory response caused by the proliferation of TH cells. They also reduce the transcription of the IL-2 gene, which is involved in the...