Practice patterns in the timing of antenatal corticosteroids for fetal lung maturity

Tracy M. Adams, Wendy L. Kinzler, Martin R. Chavez, Melissa J. Fazzari, Anthony M. Vintzileos

Research output: Contribution to journalArticle

13 Scopus citations

Abstract

Objective: To determine the practice patterns of antenatal corticosteroid (AS) administration in women with threatened preterm labor. Methods: This was a retrospective cohort of patients who received betamethasone between 2009 and 2010, identified through a pharmacy database. Patients with high order multiples; incomplete records and indicated preterm delivery were excluded. Demographic and obstetrical factors were compared between women with an AS to delivery latency of ≤7 days versus >7 days. Parametric and non-parametric tests were used as appropriate. p < 0.05 denotes statistical significance; relative risks with 95% confidence intervals were calculated. Results: Three-hundred forty-five patients were included. Sixty-eight patients (20%) received AS within 7 days of delivery. Women who received AS ≤7 days before delivery (optimal timing) were more likely to have a transvaginal cervical length ≤2 cm (RR:2.53, CI: 1.2-5.6), cervical dilation ≥2 cm (RR: 3.86, CI: 2.7-5.6) and positive fFN (RR: 2.59, CI: 1.1-6.3). Preterm premature ruptured membranes were also associated with optimal timing of AS (RR: 4.86, CI: 3.4-6.8). Conclusions: Eighty percent of patients receive suboptimal timing of AS administration. Factors associated with suboptimal timing are: cervical length >2 cm, cervical dilation <2 cm and negative fFN. Cervical assessment should be a key factor in the decision for AS administration. More research is needed for accurate timing of AS in women with threatened preterm labor.

Original languageEnglish (US)
Pages (from-to)1598-1601
Number of pages4
JournalJournal of Maternal-Fetal and Neonatal Medicine
Volume28
Issue number13
DOIs
StatePublished - Sep 2 2015
Externally publishedYes

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Keywords

  • Antenatal corticosteroids
  • decision to administer antenatal corticosteroids
  • timing of antenatal corticosteroids

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynecology

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