title: Time to delivery after the first course of antenatal corticosteroids: a cohort study.
abstract: The optimal time interval between administration of antenatal corticosteroids and delivery is 1 to 7 days. This study evaluates the timing of the first course of antenatal corticosteroids in clinical practice. We performed a retrospective cohort study of consecutive women who had received antenatal corticosteroids and/or delivered between 24 and 34 weeks of gestation. Time between administration of corticosteroids and delivery was compared between women with different causes of anticipated preterm deliveries: symptomatic preterm labor with intact membranes; preterm premature rupture of the membranes; (pre)eclampsia; hemolysis, elevated liver enzymes, and low platelet count; intrauterine growth restriction; vaginal blood loss; and suspected fetal distress. We included 439 women of whom 348 (79%) completed the course of corticosteroids. In women with a complete course, 143 (41%) delivered within 7 days. The median interval between the course and delivery was 11 days and varied between 41 days in women with vaginal blood loss, 25 days in women with spontaneous preterm labor with intact membranes, and 8 days in women with preeclampsia ( P  <  0.001). In women with spontaneous preterm labor with intact membranes and in women with vaginal blood loss, we can benefit substantially from a more accurate discrimination of women who need corticosteroids immediately and women who do not.
authors.affiliation: Department of Obstetrics and Gynecology, Academic Medical Center, Amsterdam, The Netherlands. jolandevis@gmail.com
authors.forename: Jolande Y
authors.initials: JY
authors.lastname: Vis
authors.forename: Femke F
authors.initials: FF
authors.lastname: Wilms
authors.forename: Rosanna A
authors.initials: RA
authors.lastname: Kuin
authors.forename: Janine M
authors.initials: JM
authors.lastname: Reuvers
authors.forename: Monique C
authors.initials: MC
authors.lastname: Stam
authors.forename: Desiree A P M
authors.initials: DA
authors.lastname: Pattinaja
authors.forename: Ben Willem J
authors.initials: BW
authors.lastname: Mol
mesh_terms: D000305:Adrenal Cortex Hormones / Q000008:administration & dosage* / Q000009:adverse effects; D000328:Adult; D005260:Female; D005316:Fetal Distress / Q000188:drug therapy; D005317:Fetal Growth Retardation / Q000188:drug therapy; D005322:Premature Rupture of Fetal Membranes / Q000188:drug therapy; D017359:HELLP Syndrome / Q000188:drug therapy; D006801:Humans; D007231:Infant, Newborn; D053208:Kaplan-Meier Estimate; D007752:Obstetric Labor, Premature / Q000188:drug therapy; D011225:Pre-Eclampsia / Q000188:drug therapy; D011247:Pregnancy; D011295:Prenatal Care; D012127:Respiratory Distress Syndrome, Newborn / Q000517:prevention & control*; D012189:Retrospective Studies; D013997:Time Factors
chemical_list: D000305:Adrenal Cortex Hormones