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CME Credit Offered
CME Credit Offered
Abstract Award
Abstract Award
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Poster Session 4

(1121) Trends in previable antenatal corticosteroid administration among singletons after implementation of a practice advisory

Friday, January 31, 2025
4:00 PM – 6:00 PM  
Objective: We aimed to evaluate national trends in antenatal corticosteroid administration among previable singletons after implementation of a practice advisory by the American College of Obstetricians and Gynecologists (ACOG) recommending consideration of ACS use as early as 22 0/7 weeks of gestation.

Study Design: Retrospective analysis of the United States Centers for Disease Control and Prevention Natality Live Birth Database (2016-2022). All patients with in-hospital, non-anomalous, singleton previable live births (20 0/7-23 6/7 weeks’ gestation) were eligible for inclusion. Cases where ACS exposure was unknown were excluded. Rates of ACS exposure among all births were compared before and after ACOG’s practice advisory published online in September, 2021 using Pearson’s chi-squared test. September to December 2021 was considered an implementation period and therefore excluded from the analysis. Statistical significance was set at P < 0.05.

Results: A total of 33,570 previable live births comprised the study cohort. There was a significant increase in rates of ACS administration among singletons after ACOG’s practice advisory compared to before (1,304/4,827 [27.0%] vs. 6,014/28,743 [20.9%], P < 0.001). Rates of ACS exposure stratified by gestational age before and after ACOG’s practice advisory are displayed in the Table. Trends in ACS exposure over time among births occurring before and after ACOG’s practice advisory is illustrated in the Figure.

Conclusion: Data from this large cohort demonstrates the immediate impact ACOG’s practice advisory had on administering previable ACS in singleton gestations. A significant increase in ACS exposure occurred at all previable gestational ages. Future research evaluating the impact of this practice change on neonatal outcomes during this time period is needed.