(567) Practice patterns in the administration of antenatal corticosteroids in patients at risk of preterm birth

Thursday, January 30, 2025

4:00 PM – 6:00 PM

Submitting Author and Presenting Author(s)

Moti Gulersen, MD, MSc

Assistant Professor, Obstetrics and Gynecology
Sidney Kimmel Medical College of Thomas Jefferson University
Philadelphia, Pennsylvania, United States

Coauthor(s)

Frank I. Jackson, DO (he/him/his)

Maternal Fetal Medicine Fellow
Northwell
New Hyde Park, New York, United States
Ashley N. Battarbee, MD, MSCR

Assistant Professor
Center for Women’s Reproductive Health, University of Alabama at Birmingham
Birmingham, Alabama, United States
Vincenzo Berghella, MD (he/him/his)

Professor, Director
Sidney Kimmel Medical College of Thomas Jefferson University
Philadelphia, Pennsylvania, United States
Matthew J. Blitz, MD

Director of Clinical Research, Maternal-Fetal Medicine, Northwell; Program Director, Maternal Fetal Medicine Fellowship, South Shore University Hospital
Northwell
Bay Shore, NY, United States

Objective: Although suboptimal timing of antenatal corticosteroid (ACS) administration in patients at risk of preterm birth (PTB) is well known, studies stratifying timing by GA at administration are limited. We aimed to evaluate whether ACS timing differs by gestational age (GA) of administration in patients at risk of PTB.

Study Design: Multicenter retrospective cohort of all singleton pregnancies exposed to ACS between 22 0/7-36 6/7 weeks of gestation and delivered from 2019-2023. Patients who had neonates that were not actively resuscitated at birth and intrauterine fetal demise were excluded. The primary outcome of time interval from ACS administration to delivery, stratified by < 2, 2-7, and >7 days, was compared among 4 gestational age groups: 22 0/7-25 6/7, 26 0/7-29 6/7, 30 0/7-33 6/7, and 34 0/7-36 6/7 weeks of gestation. The secondary outcome was delivery at term (37 0/7 weeks of gestation or later). Statistical analysis included use of Chi-squared test. Statistical significance was set P < 0.05.

Results: Of the 116,803 patients who delivered during the study period, 5,003 (4.3%) received ACS prior to delivery. Primary and secondary outcomes are displayed in the Table.

Conclusion: Data from this large cohort suggest that optimal timing of ACS in patients at risk of PTB is low, regardless of gestational age of ACS administration. The likelihood of optimal timing is significantly decreased in the late preterm period compared to early preterm periods. A significant proportion of patients exposed to ACS in the periviable period deliver at term. These data highlight the importance of developing PTB prediction tools to aid practitioners in optimizing the timing of ACS.