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Facility-Level Factors Associating Antenatal Corticosteroid Administration Rates and Subsequent Term Birth Rates: A
Kazuya Fuma1, Takafumi Ushida1,2, Takahiro Imaizumi3
1Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
The Journal of Obstetrics and Gynaecology Research
|March 12, 2026
Summary
Facility-level factors significantly impact antenatal corticosteroid (ACS) use in Japan. Optimizing ACS administration requires understanding these factors to improve coverage and reduce overtreatment for better maternal and infant outcomes.
Area of Science:
- Obstetrics and Gynecology
- Perinatal Medicine
- Health Services Research
Background:
- Antenatal corticosteroid (ACS) administration rates in Japan are suboptimal.
- Understanding facility-level factors is crucial for optimizing ACS use, balancing high coverage with minimal overtreatment.
Purpose of the Study:
- To identify facility-level factors associated with ACS coverage and overtreatment.
- To simulate the potential impact of increasing ACS administration rates.
Main Methods:
- Observational study using the 2020-2022 Perinatal Registry Database.
- Analyzed ACS administration rate before 34 weeks gestation (ACS/34w) and term births among ACS recipients (term/ACS).
- Multivariable regression and simulation modeling were employed.
Main Results:
- Mean ACS/34w rate was 63.4%; mean term/ACS proportion was 12.0%.
- Factors like threatened preterm labor and deliveries <34 weeks influenced ACS/34w rate.
- Facility characteristics including delivery volume and perinatal care level affected term/ACS proportion. Simulation predicted 2311 additional ACS recipients and 465 term births annually with increased coverage.
Conclusions:
- Facility-level characteristics play a significant role in ACS coverage and overtreatment.
- Findings can inform strategies to optimize ACS utilization in clinical practice.
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