{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T04:07:14Z","timestamp":1774325234396,"version":"3.50.1"},"reference-count":26,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T00:00:00Z","timestamp":1773273600000},"content-version":"vor","delay-in-days":11,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","award":["24K23509"],"award-info":[{"award-number":["24K23509"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Obstet and Gynaecol"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>The antenatal corticosteroid (ACS) administration rate in Japan is low. To achieve both high coverage and low overtreatment of ACS, understanding of facility\u2010level factors is important. This study aimed to identify facility\u2010level factors associated with ACS coverage and overtreatment and simulate the potential consequences of increased ACS use.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This observational study used data from the 2020 to 2022 Perinatal Registry Database maintained by the Japan Society of Obstetrics and Gynecology. Primary outcomes were: (1) ACS administration rate among preterm births before 34\u2009weeks (ACS\/34w rate) and (2) proportion of term births among ACS recipients (term\/ACS proportion). Multivariable regression analyses examined associations with facility\u2010level factors including perinatal care level, location, delivery volume, and prevalence of maternal conditions. A simulation estimated the impact of increasing ACS\/34w rate to 80% in facilities with lower baseline rates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In the facility\u2010level analysis of 244 facilities (376\u2009717 records), the mean ACS\/34w rate was 63.4%, and term\/ACS proportion was 12.0%. The proportion of threatened preterm labor (coefficient: 4.4 [95% confidence interval: 2.1\u20136.7]), deliveries &lt;\u200934\u2009weeks (3.0 [0.1\u20135.8]), and cesarean section rate (\u22122.4 [\u22124.5 to \u22120.2]) were significantly associated with ACS\/34w rate. ACS\/34w rate (2.0 [0.8\u20133.3]), annual delivery volume (2.1 [0.6\u20133.5]), and cesarean section rate (1.5 [0.2\u20132.7]) were positively associated with term\/ACS proportion, while perinatal care level was inversely associated (\u22123.5 [\u22126.3 to \u22120.6]). Simulation estimated 2311 additional ACS recipients and 465 term births per year.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Facility\u2010level factors influence ACS coverage and overtreatment. These findings may inform strategies for optimizing ACS use.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jog.70237","type":"journal-article","created":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T01:15:14Z","timestamp":1773364514000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Facility\u2010Level Factors Associating Antenatal Corticosteroid Administration Rates and Subsequent Term Birth Rates: A Nationwide Cross\u2010Sectional Observational Study Using the 2020\u20132022 Perinatal Registry Database in Japan"],"prefix":"10.1111","volume":"52","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3111-8349","authenticated-orcid":false,"given":"Kazuya","family":"Fuma","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology Nagoya University Graduate School of Medicine  Nagoya Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8042-5919","authenticated-orcid":false,"given":"Takafumi","family":"Ushida","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Nagoya University Graduate School of Medicine  Nagoya Japan"},{"name":"Center for Maternal\u2010Neonatal Care Nagoya University Hospital  Nagoya Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takahiro","family":"Imaizumi","sequence":"additional","affiliation":[{"name":"Department of Clinical Research Education Nagoya University Graduate School of Medicine  Nagoya Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1502-5142","authenticated-orcid":false,"given":"Sho","family":"Tano","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Nagoya University Graduate School of Medicine  Nagoya Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-9340-7809","authenticated-orcid":false,"given":"Seiko","family":"Matsuo","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Nagoya University Graduate School of Medicine  Nagoya Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Satoru","family":"Katsuki","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Nagoya University Graduate School of Medicine  Nagoya Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kenji","family":"Imai","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Nagoya University Graduate School of Medicine  Nagoya Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroaki","family":"Kajiyama","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Nagoya University Graduate School of Medicine  Nagoya Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tomomi","family":"Kotani","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Nagoya University Graduate School of Medicine  Nagoya Japan"},{"name":"Center for Maternal\u2010Neonatal Care Nagoya University Hospital  Nagoya Japan"},{"name":"Department of Obstetrics and Gynecology Hamamatsu University School of Medicine  Hamamatsu Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,3,12]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/OGX.0000000000000778"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2019.08.020"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/jog.16364"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2022.02.021"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jesp.2013.03.013"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/jog.15438"},{"issue":"2","key":"e_1_2_12_8_1","first-page":"CD004454","article-title":"Antenatal Corticosteroids for Accelerating Fetal Lung Maturation for Women at Risk of Preterm Birth","volume":"12","author":"McGoldrick E.","year":"2020","journal-title":"Cochrane Database of Systematic Reviews"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2020.3937"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-019-2174-1"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000000629"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1055\/a-1925-1435"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapediatrics.2017.0602"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0207379"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.outlook.2024.102346"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2022.28518"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(22)01535-5"},{"issue":"10","key":"e_1_2_12_18_1","first-page":"911","article-title":"Effects of Antenatal Corticosteroids on Maternal Serum Indicators of Infection in Women at Risk for Preterm Delivery: A Randomized Trial Comparing Betamethasone and Dexamethasone","volume":"17","author":"Danesh A.","year":"2012","journal-title":"Journal of Research in Medical Sciences : The Official Journal of Isfahan University of Medical Sciences"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj-2023-075835"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006250-200007000-00020"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.5694\/mja11.10717"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-019-2352-1"},{"issue":"8","key":"e_1_2_12_23_1","first-page":"CD014978","article-title":"Tocolytics for Delaying Preterm Birth: A Network Meta\u2010Analysis","volume":"8","author":"Wilson A.","year":"2022","journal-title":"Cochrane Database of Systematic Reviews"},{"key":"e_1_2_12_24_1","volume-title":"WHO Recommendation on Tocolytic Therapy for Improving Preterm Birth Outcomes","author":"World Health Organization","year":"2022"},{"key":"e_1_2_12_25_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjoq-2017-000189"},{"issue":"6","key":"e_1_2_12_26_1","first-page":"682","article-title":"Providing Antenatal Corticosteroids for Preterm Birth: A Quality Improvement Initiative in Cambodia and the Philippines","volume":"28","author":"Smith J. M.","year":"2016","journal-title":"International Journal for Quality in Health Care"},{"key":"e_1_2_12_27_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13012-017-0702-9"}],"container-title":["Journal of Obstetrics and Gynaecology Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jog.70237","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/jog.70237","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jog.70237","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T02:38:47Z","timestamp":1774319927000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1111\/jog.70237"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3]]},"references-count":26,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,3]]}},"alternative-id":["10.1111\/jog.70237"],"URL":"https:\/\/doi.org\/10.1111\/jog.70237","archive":["Portico"],"relation":{},"ISSN":["1341-8076","1447-0756"],"issn-type":[{"value":"1341-8076","type":"print"},{"value":"1447-0756","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3]]},"assertion":[{"value":"2025-09-15","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-03-02","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-03-12","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70237"}}