Antenatal corticosteroids for early preterm birth: implementation strategy lessons from the WHO ACTION-I trial

Autores
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
Año de publicación
2022
Idioma
inglés
Tipo de recurso
artículo
Estado
versión publicada
Descripción
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.
Fil: De Costa, Ayesha. Organizacion Mundial de la Salud; Argentina
Fil: Oladapo, Olufemi T.. Organizacion Mundial de la Salud; Argentina
Fil: Gupta, Shuchita. Organizacion Mundial de la Salud; Argentina
Fil: Portela, Anayda. Organizacion Mundial de la Salud; Argentina
Fil: Vogel, Joshua P.. Macfarlane Burnet Institute For Medical Research; Australia
Fil: Souza, Joao Paulo. Organizacion Mundial de la Salud; Argentina
Fil: Rao, Suman. Organizacion Mundial de la Salud; Argentina
Fil: Minckas, Nicole. Organizacion Mundial de la Salud; Argentina
Fil: Tuncalp, Özge. Organizacion Mundial de la Salud; Argentina
Fil: Bahl, Rajiv. Organizacion Mundial de la Salud; Argentina
Fil: Althabe, Fernando. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones en Epidemiología y Salud Pública. Instituto de Efectividad Clínica y Sanitaria. Centro de Investigaciones en Epidemiología y Salud Pública; Argentina
Materia
ANTENATAL CORTICOSTEROIDS
NEONATAL MORTALITY
PRETERM BIRTH
Nivel de accesibilidad
acceso abierto
Condiciones de uso
https://creativecommons.org/licenses/by/2.5/ar/
Repositorio
CONICET Digital (CONICET)
Institución
Consejo Nacional de Investigaciones Científicas y Técnicas
OAI Identificador
oai:ri.conicet.gov.ar:11336/216928
Acceder
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oai_identifier_str oai:ri.conicet.gov.ar:11336/216928
network_acronym_str CONICETDig
repository_id_str 3498
network_name_str CONICET Digital (CONICET)
spelling Antenatal corticosteroids for early preterm birth: implementation strategy lessons from the WHO ACTION-I trialDe Costa, AyeshaOladapo, Olufemi T.Gupta, ShuchitaPortela, AnaydaVogel, Joshua P.Souza, Joao PauloRao, SumanMinckas, NicoleTuncalp, ÖzgeBahl, RajivAlthabe, FernandoANTENATAL CORTICOSTEROIDSNEONATAL MORTALITYPRETERM BIRTHhttps://purl.org/becyt/ford/3.3https://purl.org/becyt/ford/3The 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.Fil: De Costa, Ayesha. Organizacion Mundial de la Salud; ArgentinaFil: Oladapo, Olufemi T.. Organizacion Mundial de la Salud; ArgentinaFil: Gupta, Shuchita. Organizacion Mundial de la Salud; ArgentinaFil: Portela, Anayda. Organizacion Mundial de la Salud; ArgentinaFil: Vogel, Joshua P.. Macfarlane Burnet Institute For Medical Research; AustraliaFil: Souza, Joao Paulo. Organizacion Mundial de la Salud; ArgentinaFil: Rao, Suman. Organizacion Mundial de la Salud; ArgentinaFil: Minckas, Nicole. Organizacion Mundial de la Salud; ArgentinaFil: Tuncalp, Özge. Organizacion Mundial de la Salud; ArgentinaFil: Bahl, Rajiv. Organizacion Mundial de la Salud; ArgentinaFil: Althabe, Fernando. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones en Epidemiología y Salud Pública. Instituto de Efectividad Clínica y Sanitaria. Centro de Investigaciones en Epidemiología y Salud Pública; ArgentinaBioMed Central2022-12info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttp://purl.org/coar/resource_type/c_6501info:ar-repo/semantics/articuloapplication/pdfapplication/pdfhttp://hdl.handle.net/11336/216928De Costa, Ayesha; Oladapo, Olufemi T.; Gupta, Shuchita; Portela, Anayda; Vogel, Joshua P.; et al.; Antenatal corticosteroids for early preterm birth: implementation strategy lessons from the WHO ACTION-I trial; BioMed Central; Health Research Policy and Systems; 20; 1; 12-2022; 1-61478-4505CONICET DigitalCONICETenginfo:eu-repo/semantics/altIdentifier/doi/10.1186/s12961-022-00941-zinfo:eu-repo/semantics/openAccesshttps://creativecommons.org/licenses/by/2.5/ar/reponame:CONICET Digital (CONICET)instname:Consejo Nacional de Investigaciones Científicas y Técnicas2025-09-03T10:12:06Zoai:ri.conicet.gov.ar:11336/216928instacron:CONICETInstitucionalhttp://ri.conicet.gov.ar/Organismo científico-tecnológicoNo correspondehttp://ri.conicet.gov.ar/oai/requestdasensio@conicet.gov.ar; lcarlino@conicet.gov.arArgentinaNo correspondeNo correspondeNo correspondeopendoar:34982025-09-03 10:12:07.108CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicasfalse
dc.title.none.fl_str_mv 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
spellingShingle Antenatal corticosteroids for early preterm birth: implementation strategy lessons from the WHO ACTION-I trial
De Costa, Ayesha
ANTENATAL CORTICOSTEROIDS
NEONATAL MORTALITY
PRETERM BIRTH
title_short 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_sort Antenatal corticosteroids for early preterm birth: implementation strategy lessons from the WHO ACTION-I trial
dc.creator.none.fl_str_mv 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 De Costa, Ayesha
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_role author
author2 Oladapo, Olufemi T.
Gupta, Shuchita
Portela, Anayda
Vogel, Joshua P.
Souza, Joao Paulo
Rao, Suman
Minckas, Nicole
Tuncalp, Özge
Bahl, Rajiv
Althabe, Fernando
author2_role author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv ANTENATAL CORTICOSTEROIDS
NEONATAL MORTALITY
PRETERM BIRTH
topic ANTENATAL CORTICOSTEROIDS
NEONATAL MORTALITY
PRETERM BIRTH
purl_subject.fl_str_mv https://purl.org/becyt/ford/3.3
https://purl.org/becyt/ford/3
dc.description.none.fl_txt_mv 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.
Fil: De Costa, Ayesha. Organizacion Mundial de la Salud; Argentina
Fil: Oladapo, Olufemi T.. Organizacion Mundial de la Salud; Argentina
Fil: Gupta, Shuchita. Organizacion Mundial de la Salud; Argentina
Fil: Portela, Anayda. Organizacion Mundial de la Salud; Argentina
Fil: Vogel, Joshua P.. Macfarlane Burnet Institute For Medical Research; Australia
Fil: Souza, Joao Paulo. Organizacion Mundial de la Salud; Argentina
Fil: Rao, Suman. Organizacion Mundial de la Salud; Argentina
Fil: Minckas, Nicole. Organizacion Mundial de la Salud; Argentina
Fil: Tuncalp, Özge. Organizacion Mundial de la Salud; Argentina
Fil: Bahl, Rajiv. Organizacion Mundial de la Salud; Argentina
Fil: Althabe, Fernando. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones en Epidemiología y Salud Pública. Instituto de Efectividad Clínica y Sanitaria. Centro de Investigaciones en Epidemiología y Salud Pública; Argentina
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.
publishDate 2022
dc.date.none.fl_str_mv 2022-12
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
http://purl.org/coar/resource_type/c_6501
info:ar-repo/semantics/articulo
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv http://hdl.handle.net/11336/216928
De Costa, Ayesha; Oladapo, Olufemi T.; Gupta, Shuchita; Portela, Anayda; Vogel, Joshua P.; et al.; Antenatal corticosteroids for early preterm birth: implementation strategy lessons from the WHO ACTION-I trial; BioMed Central; Health Research Policy and Systems; 20; 1; 12-2022; 1-6
1478-4505
CONICET Digital
CONICET
url http://hdl.handle.net/11336/216928
identifier_str_mv De Costa, Ayesha; Oladapo, Olufemi T.; Gupta, Shuchita; Portela, Anayda; Vogel, Joshua P.; et al.; Antenatal corticosteroids for early preterm birth: implementation strategy lessons from the WHO ACTION-I trial; BioMed Central; Health Research Policy and Systems; 20; 1; 12-2022; 1-6
1478-4505
CONICET Digital
CONICET
dc.language.none.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv info:eu-repo/semantics/altIdentifier/doi/10.1186/s12961-022-00941-z
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
https://creativecommons.org/licenses/by/2.5/ar/
eu_rights_str_mv openAccess
rights_invalid_str_mv https://creativecommons.org/licenses/by/2.5/ar/
dc.format.none.fl_str_mv application/pdf
application/pdf
dc.publisher.none.fl_str_mv BioMed Central
publisher.none.fl_str_mv BioMed Central
dc.source.none.fl_str_mv reponame:CONICET Digital (CONICET)
instname:Consejo Nacional de Investigaciones Científicas y Técnicas
reponame_str CONICET Digital (CONICET)
collection CONICET Digital (CONICET)
instname_str Consejo Nacional de Investigaciones Científicas y Técnicas
repository.name.fl_str_mv CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicas
repository.mail.fl_str_mv dasensio@conicet.gov.ar; lcarlino@conicet.gov.ar
_version_ 1842270185604513792
score 12.885934

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