Background:
The discovery of the benefits of antenatal corticosteroids (ACS) for preterm
infants was one of the most significant developments in obstetric care. However, due to the
difficulty in predicting preterm delivery, optimal use of ACS, is challenging.
Objective:
To describe prescribing practices for antenatal corticosteroids (ACS) at a tertiary hospital
over five years to determine whether ACS were received at optimal timing; to determine patient
characteristics of women receiving ACS at optimal timing; to determine patient characteristics of
those who did not receive ACS as indicated and to examine the trend in ACS prescribing over the
study period.
Methods:
We performed a retrospective study of all deliveries from January 2011 to December
2015. The rates of ACS prescription for each group of women (preterm, late preterm, and term)
were recorded and analysed.
Results:
A total of 65% of women who delivered before 34 weeks’ gestation received ACS. Of
these women, 63% delivered within 7 days of receiving ACS. Women most likely to receive ACS
with optimal timing were primiparous (relative risk [RR], 1.25 [CI, 1.08-1.45]), or women diagnosed
with pre-eclampsia (RR, 1.34 [CI 1.10-1.63]), preterm premature rupture of membranes (RR,
1.33 [CI, 1.15-1.54]) or threatened preterm labour (RR, 1.42 [CI, 1.22-1.65]).
Conclusion:
A significant number of women and babies are exposed to ACS without commensurate
benefit, and a significant number who deliver preterm do not receive ACS. The percentage of
preterm and term infants receiving ACS should be determined to optimise service delivery.
Accessibility of Prenatal Care Can Affect Inequitable Health Outcomes of Pregnant Women Living in Obstetric Care Underserved Areas: a Nationwide Population-Based Study