The adrenal cortex produces a hormone class known as corticosteroids, which play various roles in the body. It is usual to utilize exogenous corticosteroids to reduce inflammation, inhibit the immune system, and replenish hormone levels in the body when one is missing. Mothers at risk of having a premature baby may be given corticosteroids to help prevent acute respiratory distress syndrome in their newborns (ARDS). This project is an evidence-based practice carried out on pregnant mothers with a high risk of being infected with COVID-19. The use of corticosteroids in these pregnant mothers in the three studies evaluated the effectiveness of the antenatal corticosteroid among pregnant women depending on their ages. Evidence-based practices are the best way for nurses in the hospital to research while practicing new favorable ideas and can lead to improved health for the patients. The EBP makes nurses more experienced with current information in their field, which improves patient outcomes. The practice of using the corticosteroid in pregnant mothers is to know the best and most appropriate use of the drug to reduce the effect of COVID-19 on them. The aim is to reduce the mortality rates of infants and mothers.
The main question about this evidence-based practice is if corticosteroids can help reduce the infection of covid-19 in pregnant women. The targeted group is pregnant women with high chances of being infected with COVID-19. In this review, three sources were carried out in the evidence-based practices to determine the effectiveness of the corticosteroids. According to Packer, in the study of the decision-analytic model, 10000 women were pregnant. The women were administered the antenatal corticosteroid at their high risk of delivery and those infected with covid -19 (Packer et al., 2020). Of those women administered with a corticosteroid, 2200 went into the Intensive Care Unit (ICU), and there were 110 deaths from the material. Of those women who were not administered corticosteroids, 1500 went into ICU, and 75 of them had maternal death. The use of antenatal corticosteroids in pregnant women with covid-19 infection causes a higher death in the mothers and a lower death in the infant outcome (Packer et al., 2020). Karakas disagrees with Packer in the article where the study of determining whether “corticosteroid and anakinra treatment be effective option in pregnant women with severe civid-19” (Karakas et al., 2021) used a sample of 14 women in a retrospective observational cohort study who were pregnant and over 18 years old. After the study had a death rate of 7.1%, the Karakas study concludes that using anakinra and corticosteroids as means of treatment in the early stages in pregnant women with covid-19 has severe consequences a positive effect on reducing the disease progress. Karakas’ study disagrees with Packer’s study. Following their conclusion on the use of corticosteroids in pregnant mothers and their effects on mortality.
Another qualitative study by Ssekandi about “corticosteroids use in pregnant women with COVID-19” shows that common use of the corticosteroid in early stages will reduce the cause of death among pregnant mothers (Ssekandi et al., 2021). However, the use of corticosteroids in an excess manner may negatively affect both the mothers and the infants. Ssekandi agrees with Karakas in one way and agrees with Packer also in another way. The three sources explain both the negative and positive impacts of the corticosteroid on pregnant women. All the authors express their views using different study methods. Karakas’ study used a small sample, making it a limitation of the study; it also did not have a control group.
Karakaş, Ö., Erden, A., Ünlü, S., Erol, S. A., Goncu Ayhan, Ş., Özdemir, B., … & Küçükşahin, O. (2021). Can Anakinra and corticosteroid treatment be an effective option in pregnant women with severe Covid-19?. Women & Health, 61(9), 872-879.
Packer, C. H., Zhou, C. G., Hersh, A. R., Allen, A. J., Hermesch, A. C., & Caughey, A. B. (2020). Antenatal corticosteroids for pregnant women at high risk of preterm delivery with COVID-19 infection: a decision analysis. American journal of perinatology, 37(10), 1015-1021.
Ssekandi, A. M., Sserwanja, Q., Olal, E., Kawuki, J., & Adam, M. B. (2021). Corticosteroids use in pregnant women with COVID-19: recommendations from available evidence. Journal of Multidisciplinary Healthcare, 14, 659.