{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T08:58:01Z","timestamp":1740128281208,"version":"3.37.3"},"reference-count":20,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2016,9,23]],"date-time":"2016-09-23T00:00:00Z","timestamp":1474588800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100009888","name":"Regione Toscana","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100009888","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Paediatrica"],"published-print":{"date-parts":[[2017,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>All women delivering a preterm infant should receive antenatal corticosteroid prophylaxis, but many miss this opportunity. We determined the risk factors associated with missed prophylaxis in a geographically defined area of Italy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We prospectively studied all mothers who delivered babies between 24 and 31 completed weeks of gestation, from 2009 to 2013, in all maternity units in Tuscany.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 1232 mothers, 186 (15.1%) did not receive prophylaxis. The risk was higher in migrant mothers, with an adjusted risk ratio (<jats:styled-content style=\"fixed-case\">RR<\/jats:styled-content>) of 1.28 and 95% confidence interval (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>) of 1.04\u20131.56, and in mothers hospitalised for less than 24 hours (<jats:styled-content style=\"fixed-case\">RR<\/jats:styled-content> 4.09, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>: 2.90\u20135.78). Preterm prelabour rupture of membranes (<jats:styled-content style=\"fixed-case\">RR<\/jats:styled-content> 0.63, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>: 0.41\u20130.96) and maternal antepartum transfer (<jats:styled-content style=\"fixed-case\">RR<\/jats:styled-content> 0.24, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>: 0.18\u20130.32) were protective. Hospital level at birth and gestational age did not influence the prophylaxis rate. The population\u2010attributable fractions were 50.4% for late hospital admissions and 10.2% for migrant status.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In a highly organised network of hospitals, neither level of care nor gestational age influenced prophylaxis. Timely arrival of women in hospital, better recognition of the imminence of delivery and tighter steroids administration guidelines are the most relevant targets to further increase prophylaxis.<\/jats:p><\/jats:sec>","DOI":"10.1111\/apa.13563","type":"journal-article","created":{"date-parts":[[2016,8,31]],"date-time":"2016-08-31T07:23:03Z","timestamp":1472628183000},"page":"250-255","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Area\u2010based study identifies risk factors associated with missed antenatal corticosteroid prophylaxis in women delivering preterm infants"],"prefix":"10.1111","volume":"106","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6074-8975","authenticated-orcid":false,"given":"Luigi","family":"Gagliardi","sequence":"first","affiliation":[{"name":"Department of Woman and Child Health Versilia Hospital Viareggio Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carolina","family":"Amador","sequence":"additional","affiliation":[{"name":"Department of Fetal\u2010Neonatal Medicine Anna Meyer Children's University Hospital Florence Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Monia","family":"Puglia","sequence":"additional","affiliation":[{"name":"Health Agency of Tuscany Florence Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Federico","family":"Mecacci","sequence":"additional","affiliation":[{"name":"Department of Gynecology, Perinatology and Human Reproduction Careggi University Hospital Florence Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simone","family":"Pratesi","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, Psychology, Drug Research and Child Health Careggi University Hospital Florence Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emilio","family":"Sigali","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Division of Neonatology and Neonatal Intensive Care Unit University Hospital of Pisa Pisa Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Barbara","family":"Tomasini","sequence":"additional","affiliation":[{"name":"Neonatal Intensive Care Unit University Hospital of Siena Siena Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Franca","family":"Rusconi","sequence":"additional","affiliation":[{"name":"Unit of Epidemiology Anna Meyer Children's University Hospital Florence Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"TIN Toscane on\u2010line Group","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2016,9,23]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1995.03520290065031"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e31820eee00"},{"key":"e_1_2_11_4_1","unstructured":"Royal College of Obstetricians and Gynaecologists.Antenatal Corticosteroids to Reduce Neonatal Morbidity and Mortality. 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