Use of Antenatal Corticosteroid Therapy: A Descriptive Study of Clinical Practice Trends
| Autor: | Amélie Boutin, Cédric Gasse, Suzanne Demers, Alexandre Fillion, Laurence Labine, Caroline Gaudreau, Emmanuel Bujold, Audrée Gareau-Léonard |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
medicine.medical_specialty Gestational Age Infant Premature Diseases Betamethasone Dexamethasone Drug Administration Schedule 03 medical and health sciences 0302 clinical medicine Adrenal Cortex Hormones Pregnancy Medicine Humans 030212 general & internal medicine Retrospective Studies 030219 obstetrics & reproductive medicine business.industry Obstetrics Preterm labour Obstetrics and Gynecology Antenatal corticosteroid medicine.disease Perinatal morbidity Clinical Practice Short cervix Practice Guidelines as Topic Premature Birth Female Guideline Adherence business Cohort study |
| Zdroj: | Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC. 41(3) |
| ISSN: | 1701-2163 |
| Popis: | Objectives Antenatal corticosteroids (ACS) received within 7 days of delivery reduce perinatal morbidity and mortality associated with preterm birth. We aimed to describe the trends of ACS administration over the last decade. Methods A cohort study of women who received ACS in 2006, 2011, and 2016 at the CHU de Quebec–Universite Laval was conducted. The indication, GA at ACS, and GA at birth, were collected in 150 women randomly selected in each studied year. Our main endpoints were the frequency of ACS administration within 7 days of delivery and between 48 hours and 7 days before delivery. Results We included 447 women who received ACS at a median GA of 31.4 (range 23.6–39.0) weeks. No women received ACS after 35 weeks in 2006 and 2011. The administration of ACS for indicated delivery between 35 and 39 weeks occurred only in the last study period. Among women for whom ACS was initiated before 35 weeks, 31% received ACS in the 7 days before delivery, and only 13% received ACS between 48 hours and 7 days before birth (varying from 12% to 16%, P = 0.57). Threatened preterm labour or short cervix were the indication for ACS initiation in 39% women who received ACS before 35 weeks, but less than 5% of these women delivered between 2 and 7 days and more than 90% delivered after 14 days. Conclusions Administration of ACS remains suboptimal. Threatened preterm labour and short cervix are poorly related to optimal use of ACS therapy. |
| Databáze: | OpenAIRE |
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