Antenatal corticosteroids administration: are we giving them at the right time?

• Published in: Archives of gynecology and obstetrics 2018-02, Vol.297 (2), p.373-379
• Main Authors: Wong, Tiffany Tuck Chin, Tung, Janice Su Zhen, Lau, Hester Chang Qi, Tagore, Shephali
• Format: Article
• Language: English
• Subjects: Age; Endocrinology; General Gynecology; Gynecology; Human Genetics; Medicine; Medicine & Public Health; Obstetrics/Perinatology/Midwifery; Premature birth; Respiratory distress syndrome; Ultrasonic imaging; Womens health
• ISSN: 0932-0067; 1432-0711
• DOI: 10.1007/s00404-017-4577-4

Objective Antenatal corticosteroids before preterm births are considered to be most effective 48 h after and up to 1 week after the first dose. We aim to evaluate: (1) our practice of administration of antenatal corticosteroids in Singapore; (2) admission characteristics of women for discriminatory factors of spontaneous preterm delivery within 1 week. Methods This is a retrospective study in a tertiary obstetrics unit in Singapore. 3044 women who delivered live births (at term or preterm) from 1st November 2014 to 31st January 2015, who were at risk of spontaneous or induced preterm delivery, were included. Data related to the time of and indications for antenatal corticosteroids administration, characteristics assessed at the time of presentation, and time of delivery were collected and analysed. Results 85.9% of women who delivered at gestational age ≤ 34 +6 received at least one dose. 22.1% had delivered within the window of efficacy. Gestational age > 32 weeks at presentation, uterine activity on tocography and cervical dilation with effacement were associated with preterm delivery within 1 week of presentation. Conclusion Overall, our antenatal corticosteroids administration rate is comparable to that attained by centres in other developed countries. It is difficult but important to discriminate women who will benefit from this timely intervention.