Prescribing patterns of antenatal corticosteroids in women with threatened preterm labor

Femke F. Wilms, Gert Jan Van Baaren, Jolande Y. Vis, Martijn A. Oudijk, Anneke Kwee, Martina M. Porath, Hubertina C.J. Scheepers, Marc E.A. Spaanderman, Kitty W.M. Bloemenkamp, Antoinette C. Bolte, Caroline J. Bax, Jérôme M.J. Cornette, Johannes J. Duvekot, Bas W.A. Nij Bijvank, Jim Van Eyck, Maureen T.M. Franssen, Krystyna M. Sollie, Frank P.H.A. Vandenbussche, Mallory D. Woiski, Joris A.M. Van Der PostPatrick M.M. Bossuyt, Brent C. Opmeer, Ben W.J. Mol

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Abstract

Abstract Objective To assess the impact of cervical length (CL) measurement and fetal fibronectin testing (fFN) on the clinicians' decision to prescribe antenatal corticosteroids (ACS) to women with symptoms of preterm labor. Study design This is a secondary analysis of a prospective cohort study including women with symptoms of preterm labor and intact membranes between 24 and 34 weeks' gestation. We compared the proportion prescribed and completed ACS courses, preterm delivery within seven days and median intervals from ACS to delivery in four groups: group 1 CL < 10 mm, group 2 CL 10-30 mm and positive fFN, group 3 CL 10-30 mm and negative fFN, group 4 CL > 30 mm. Results ACS were prescribed to 63/65 (97%) women in group 1, 176/192 (91%) in group 2, 111/172 women (65%) in group 3 and 55/242 (23%) in group 4. In group 1, 42 (65%) women delivered within seven days, compared to 34 (18%) in group 2, 6 (3%) in group 3 and 3 (1%) in group 4. Median intervals between ACS and delivery were 6 days (IQR 3-61 days), 44 days (IQR 17-69 days), 53 days (IQR 37-77 days) and 66 days (IQR 43-78 days) in group 1, 2, 3 and 4 respectively. Conclusion ACS were prescribed frequently to women with a CL of 10-30 mm and a negative fFN test or a CL > 30 mm. There is room for improvement in the prescription of ACS in these low risk women.

Original languageEnglish
Article number9017
Pages (from-to)47-53
Number of pages7
JournalEuropean Journal of Obstetrics & Gynecology and Reproductive Biology
Volume192
DOIs
Publication statusPublished - 1 Jan 2015
Externally publishedYes

Keywords

  • Antenatal corticosteroids
  • Cervical length
  • Fetal fibronectin
  • Preterm labor

Cite this

Wilms, F. F., Van Baaren, G. J., Vis, J. Y., Oudijk, M. A., Kwee, A., Porath, M. M., Scheepers, H. C. J., Spaanderman, M. E. A., Bloemenkamp, K. W. M., Bolte, A. C., Bax, C. J., Cornette, J. M. J., Duvekot, J. J., Nij Bijvank, B. W. A., Van Eyck, J., Franssen, M. T. M., Sollie, K. M., Vandenbussche, F. P. H. A., Woiski, M. D., ... Mol, B. W. J. (2015). Prescribing patterns of antenatal corticosteroids in women with threatened preterm labor. European Journal of Obstetrics & Gynecology and Reproductive Biology, 192, 47-53. [9017]. https://doi.org/10.1016/j.ejogrb.2015.06.008