Measure Steward: Appropriate Use of Antenatal Steroids

Background
In the fall of 2008, The National Quality Forum initiated a Perinatal Care Project designed to identify perinatal measures that will assess the quality of perinatal care.

The National Quality Forum invited the submission of performance measures from interested parties throughout the country. Twenty-three measures were submitted and the Steering Committee endorsed 17 of the twenty-three.

Mark Tomlinson, MD, Regional Director of Obstetrics Services, Providence Health Systems, Portland, OR in conjunction with the National Perinatal Information Center/Quality Analytic Services (NPIC/QAS) submitted one of the endorsed measures: Appropriate Use of Antenatal Steroids. The measure was given a two year time-limited endorsement. During this period the measure "stewards" will field test the measure to demonstrate the reliability and validity of the data as well as the fact that outcomes do not vary by patient characteristics.

Measure Definition:
Numerator Statement: The number of mothers receiving antenatal steroids (corticosteroids administered IM) during pregnancy at any time prior to the delivery of a preterm (24-32 weeks gestation with premature rupture of membranes, or 24-34 weeks gestation with intact membranes) infant.

Denominator Statement: Total number of mothers who delivered preterm infants (24-32 weeks gestation with premature rupture of membranes, or 24-34 weeks gestation with intact membranes).

References/Scientific Acceptability:
2007 Guidelines for Perinatal Care, Sixth Edition, American Academy of Pediatrics and the American College of Obstetrics and Gynecologists, ISBN 97-1-58110-270-3; ISBN 978-1-932328-36-3 pp178-181
http://www.acog.org/bookstore/Guidelines_for_Perinatal_Care,_Sixth_Edition_P262.cfm

NIH Consensus Development Conference Statement: The Effect of Corticosteroids for Fetal Maturation on Perinatal Outcomes February 28- March 2, 1994
http://consensus.nih.gov/1994/1994AntenatalSteroidPerinatal095html.htm


If you have any questions regarding this measure, please e-mail Janet Muri, President NPIC/QAS, or call 401-274-0650.

Posted: May 22, 2009