Trends in antenatal corticosteroid administration: did our timing improve?
J Perinat Med
; 52(5): 501-508, 2024 Jun 25.
Article
en En
| MEDLINE
| ID: mdl-38662540
ABSTRACT
OBJECTIVES:
We aimed to analyze trends in the rate of effective antenatal corticosteroid prophylaxis (ACS) administrations across a spectrum of typical diagnoses associated with preterm birth.METHODS:
In this retrospective study we utilized delivery data after ACS from 2014 to 2020 at Charité Berlin, Germany. We evaluated the rate of effective ACS administrations defined as ≤10 days between last dose of ACS and delivery as well as the rate of post-ACS births on/after 37 + 0 weeks. We explored conditions associated with high rates of ineffective ACS administrations (>10 days before delivery). We analyzed the trend of ACS-effectiveness during the study period in the overall cohort and in placental dysfunction and cervical insufficiency diagnoses.RESULTS:
The overall rate of effective ACS administrations was 42â¯% (709/1,672). The overall percentage of deliveries after/at 37 + 0 weeks following ACS administration was 19â¯% (343). Placenta previa, twin pregnancy and isthmocervical insufficiency were associated with ineffective ACS (19-34â¯% effective i.e. ≤10 days before delivery). The overall ratio of effective ACS applications rose over time (p=0.002). Over the course of this study ACS effectiveness increased in placental dysfunction and isthmocervical insufficiency diagnoses (p=0.028; p=0.001).CONCLUSIONS:
Compared to a previous publication we found a decrease of post-ACS deliveries after/at 37 + 0 weeks (19 vs. 27â¯%). Ineffective ACS administrations are still frequent in patients with placenta previa, twin pregnancy and isthmocervical insufficiency. It remains to be investigated in future trials if the introduction of new diagnostic tools such as soluble Fms-like tyrosinkinase-1/placental growth factor (sFlt-1/PlGF) testing and placental alpha-microglobulin-1 (PAMG-1) testing directly led to an increased ACS effectiveness.Palabras clave
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Corticoesteroides
/
Nacimiento Prematuro
Límite:
Adult
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Female
/
Humans
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Newborn
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Pregnancy
Idioma:
En
Revista:
J Perinat Med
Año:
2024
Tipo del documento:
Article
País de afiliación:
Alemania