Antenatal Corticosteroid Treatment - March of Dimes Big 5 State Perinatal Collaborative
- Proven reduction in neonatal morbidity and mortality
- Goal of 100% administration to at-risk mothers are not being met
- Optimal timing of ACT 24 hours - 7 days prior to preterm delivery is often not achieved
- Lack of understanding and standardized ACT protocols leads to inconsistent medical practice
- Poor documentation of ACT
Breast Milk in the NICU
Breast milk is the optimal source of nutrition for babies, especially those under 1,500 grams at birth. Benefits include improved gastrointestinal maturity, better feeding tolerance and reduced risk of life-threatening infections such as sepsis and necrotizing enterocolitis. Infants fed human milk have lower mortality, better visual development, fewer chronic diseases later in life (including obesity, diabetes, asthma and cancer) and higher IQ scores. Breast feeding promotes mother-infant bonding, improves mother's health, and reduces length of stay and health care costs.
However, only 45.7% of infants cared for in Florida NICUs in 2013 received any breast milk through discharge. FPQC proposes an evidence-based statewide NICU quality improvement initiative to determine and remove barriers to human milk use for these at-risk infants. Goals include improved growth, reduced infections and shorter hospitalizations for the smallest and sickest of Florida’s culturally diverse babies, many of whom are disproportionately affected by prematurity and inadequate nutrition.
Pregnancy HypertensionInterest in an initiative focused on Hypertension in Pregnancy has grown in Florida and nationally. From 1999-2012 hypertensive disorders caused 15.5% of pregnancy-related deaths.
Maternal mortality review reports from North Carolina and California found that maternal deaths due to hypertensive disorders had significant prevention opportunities. Hypertension will be the FPQC's next focus to reduce maternal morbidity and mortality.