Charlotte Humbeck1, Sinje Jonassen2, Arne Bringewatt2,3, Mascha Pervan2, Achim Rody2, Verena Bossung4,5. 1. Department of Pediatrics, University Hospital of Würzburg, Würzburg, Germany. 2. Department of Obstetrics and Gynecology, University Hospital of Schleswig-Holstein, Campus Lübeck, Lübeck, Germany. 3. Department of Obstetrics and Gynecology, Westküstenklinikum Heide, Heide, Germany. 4. Department of Obstetrics and Gynecology, University Hospital of Schleswig-Holstein, Campus Lübeck, Lübeck, Germany. verena.bossung@usz.ch. 5. Department of Obstetrics, University Hospital of Zürich, Zürich, Switzerland. verena.bossung@usz.ch.
Abstract
PURPOSE: To evaluate the timing of antenatal steroid administration and associated medical interventions in women with imminent preterm birth. METHODS: We performed a prospective observational study at a single tertiary center in Germany from September 2018 to August 2019. We included pregnant women who received antenatal steroids for imminent preterm birth and evaluated the interval from administration to birth. 120 women with antenatal steroid application were included into our analysis. Descriptive statistics were performed to analyze factors influencing the timing of antenatal steroids and to evaluate additional medical interventions which women with imminent preterm birth experience. RESULTS: Of the 120 women included into our study, 35.8% gave birth before 34/0 weeks and 64.2% before 37/0 weeks of gestation. Only 25/120 women (20.8%) delivered within the optimal time window of 1-7 days after antenatal steroid application. 5/120 women (4.2%) only received one dose of antenatal steroids before birth and 3/120 (2.5%) gave birth within 8 to 14 days after antenatal steroids. Most women gave birth more than 14 days after steroid application (72.5%, 87/120). Women with preeclampsia (60%), PPROM (31%), and FGR (30%) had the highest rates of delivery within the optimal time window. Women of all timing groups received additional interventions and medications like antibiotics, tocolytics, or anticoagulation. CONCLUSION: Our observational data indicate that most pregnant women do not give birth within 7 days after the administration of antenatal steroids. The timing was best for preterm birth due to preeclampsia, PPROM, and FGR. Especially for women with symptoms of preterm labor and bleeding placenta previa, antenatal steroids should be indicated more restrictively to improve neonatal outcome and reduce untimely and unnecessary interventions.
PURPOSE: To evaluate the timing of antenatal steroid administration and associated medical interventions in women with imminent preterm birth. METHODS: We performed a prospective observational study at a single tertiary center in Germany from September 2018 to August 2019. We included pregnant women who received antenatal steroids for imminent preterm birth and evaluated the interval from administration to birth. 120 women with antenatal steroid application were included into our analysis. Descriptive statistics were performed to analyze factors influencing the timing of antenatal steroids and to evaluate additional medical interventions which women with imminent preterm birth experience. RESULTS: Of the 120 women included into our study, 35.8% gave birth before 34/0 weeks and 64.2% before 37/0 weeks of gestation. Only 25/120 women (20.8%) delivered within the optimal time window of 1-7 days after antenatal steroid application. 5/120 women (4.2%) only received one dose of antenatal steroids before birth and 3/120 (2.5%) gave birth within 8 to 14 days after antenatal steroids. Most women gave birth more than 14 days after steroid application (72.5%, 87/120). Women with preeclampsia (60%), PPROM (31%), and FGR (30%) had the highest rates of delivery within the optimal time window. Women of all timing groups received additional interventions and medications like antibiotics, tocolytics, or anticoagulation. CONCLUSION: Our observational data indicate that most pregnant women do not give birth within 7 days after the administration of antenatal steroids. The timing was best for preterm birth due to preeclampsia, PPROM, and FGR. Especially for women with symptoms of preterm labor and bleeding placenta previa, antenatal steroids should be indicated more restrictively to improve neonatal outcome and reduce untimely and unnecessary interventions.
Authors: Mikael Norman; Aurelie Piedvache; Klaus Børch; Lene Drasbek Huusom; Anna-Karin Edstedt Bonamy; Elizabeth A Howell; Pierre-Henri Jarreau; Rolf F Maier; Ole Pryds; Liis Toome; Heili Varendi; Tom Weber; Emilija Wilson; Arno Van Heijst; Marina Cuttini; Jan Mazela; Henrique Barros; Patrick Van Reempts; Elizabeth S Draper; Jennifer Zeitlin Journal: JAMA Pediatr Date: 2017-07-01 Impact factor: 16.193
Authors: Hannah Blencowe; Simon Cousens; Mikkel Z Oestergaard; Doris Chou; Ann-Beth Moller; Rajesh Narwal; Alma Adler; Claudia Vera Garcia; Sarah Rohde; Lale Say; Joy E Lawn Journal: Lancet Date: 2012-06-09 Impact factor: 79.321