Evaluation of antenatal corticosteroid prescribing patterns among 984 women at risk for preterm delivery

J Matern Fetal Neonatal Med. 2014 Mar;27(5):516-9. doi: 10.3109/14767058.2013.821975. Epub 2013 Aug 2.

Abstract

Objective: To evaluate the prescribing patterns of the first antenatal corticosteroids (ACS) course in our tertiary referral centre from 2005 until 2010.

Study design: We conducted a retrospective cohort study including all women who received ACS between 24(+0) and 34(+0) weeks of gestation. Main outcome measure was the number of women who delivered within 7 d after ACS administration. The time interval from administration to delivery was compared between women with different indications. Furthermore, all women delivering between 24(+0) and 34(+0) weeks of gestation who did not receive ACS were identified.

Results: 1008 women received ACS, 15 (1.5%) women were lost to follow up. Main indications were suspected preterm labour, preterm prelabour rupture of membranes, maternal indication, foetal indication and vaginal blood loss (VBL). Overall, 447 (45.4%) women delivered ≤7 d after ACS administration. This percentage was 13.6% in women with VBL and 61.5% in women with maternal indication. During the study period, 1267 women delivered before 34 weeks of gestation, 126 (9.9%) women did not receive ACS.

Conclusions: The time interval from ACS administration to delivery differs per indication. Women with VBL are most often over treated. The timing of the first ACS course should be improved.

MeSH terms

  • Adrenal Cortex Hormones / therapeutic use*
  • Adult
  • Delivery, Obstetric / statistics & numerical data
  • Female
  • Humans
  • Infant, Newborn
  • Obstetric Labor, Premature / epidemiology
  • Obstetric Labor, Premature / etiology
  • Obstetric Labor, Premature / prevention & control*
  • Practice Patterns, Physicians' / statistics & numerical data*
  • Pregnancy
  • Pregnancy Outcome / epidemiology
  • Retrospective Studies
  • Risk Factors

Substances

  • Adrenal Cortex Hormones