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Related Experiment Videos

Hospital-Level Variation in Antenatal Corticosteroids for Late Preterm Births.

Mark A Clapp, Dohyun Lee, Siguo Li

    Medrxiv : the Preprint Server for Health Sciences
    |June 29, 2026
    PubMed
    Summary

    Hospital use of late-preterm steroids varies significantly across the US. Urban hospitals and those with more 34-week births show higher adoption rates, indicating a need to explore local factors influencing evidence-based practice implementation.

    Related Experiment Videos

    Area of Science:

    • Obstetrics and Gynecology
    • Neonatal Medicine
    • Health Services Research

    Background:

    • Antenatal corticosteroids (ACS) are crucial for preterm infant lung maturation.
    • Evidence supports ACS use in late preterm infants (34-36 weeks gestation).
    • Adoption of ACS in late preterm deliveries may vary across healthcare systems.

    Purpose of the Study:

    • To assess the extent of variation in hospital-level use of antenatal corticosteroids for late-preterm singleton deliveries in the US.
    • To identify hospital characteristics associated with higher adoption rates of these steroids.

    Main Methods:

    • Retrospective cohort study using the Premier Healthcare Database (2015-2022).
    • Analyzed singleton births (34-36 weeks gestation) with betamethasone exposure.
    • Calculated hospital-level adoption rates and used logistic regression to identify predictors of high adoption.

    Main Results:

    • 728 hospitals and over 5.4 million births were analyzed; 6.6% were late preterm singleton births.
    • Hospital steroid exposure rates varied widely (0-82%), with median rates increasing across quartiles.
    • Urban location and higher proportions of 34-week births predicted high adoption; Southern hospitals had lower odds.

    Conclusions:

    • Significant heterogeneity exists in US hospital adoption of late-preterm steroids post-ALPS Trial.
    • Urban setting and specific gestational age distributions are linked to higher ACS use.
    • Further investigation into local factors is needed to understand variations in evidence-based practice adoption.