Disparities in the use of antenatal corticosteroids among women with hypertension in North Carolina

Objective To evaluate antenatal corticosteroids (ANS) use in pregnant women with hypertension. Study design Retrospective analysis of ANS use in the Perinatal Quality Collaborative of North Carolina between 2015 and 2017. Results Twenty-five centers participated, with 9% (1580/17,692) of mothers delivering at <34 weeks; of these, 81% (1286/1580) received a full course of ANS, which was not different between phases ( p = 0.32), or between Level III/IV neonatal intensive care units (NICUs; 82%), and I/II NICUs (76%) ( p = 0.05). In Level III/IV NICUs, White mothers were more likely to receive ANS (87%) than African Americans (77%) or other race/ethnicity (80%) (including Hispanics) ( p = 0.001). ANS use did not differ among mothers with different payers ( p = 0.94). Conclusion The rates of full ANS courses did not significantly increase from 2015–2017 and disparities persisted. Targeted efforts to improve ANS exposures among hypertensive African American and Hispanic mothers, as well as in community hospital settings are needed.