title: Prescribing patterns of antenatal corticosteroids in women with threatened preterm labor.
abstract: OBJECTIVE
  To assess the impact of cervical length (CL) measurement and fetal fibronectin testing (fFN) on the clinicians' decision to prescribe antenatal corticosteroids (ACS) to women with symptoms of preterm labor.
  
  
  METHODS
  This is a secondary analysis of a prospective cohort study including women with symptoms of preterm labor and intact membranes between 24 and 34 weeks' gestation. We compared the proportion prescribed and completed ACS courses, preterm delivery within seven days and median intervals from ACS to delivery in four groups: group 1 CL<10 mm, group 2 CL 10-30 mm and positive fFN, group 3 CL 10-30 mm and negative fFN, group 4 CL>30 mm.
  
  
  RESULTS
  ACS were prescribed to 63/65 (97%) women in group 1, 176/192 (91%) in group 2, 111/172 women (65%) in group 3 and 55/242 (23%) in group 4. In group 1, 42 (65%) women delivered within seven days, compared to 34 (18%) in group 2, 6 (3%) in group 3 and 3 (1%) in group 4. Median intervals between ACS and delivery were 6 days (IQR 3-61 days), 44 days (IQR 17-69 days), 53 days (IQR 37-77 days) and 66 days (IQR 43-78 days) in group 1, 2, 3 and 4 respectively.
  
  
  CONCLUSIONS
  ACS were prescribed frequently to women with a CL of 10-30 mm and a negative fFN test or a CL>30 mm. There is room for improvement in the prescription of ACS in these low risk women.
authors.affiliation: Department of Obstetrics & Gynecology, Catharina Hospital, Eindhoven, Netherlands. Electronic address: femke_wilms@hotmail.com.
authors.forename: Femke F
authors.initials: FF
authors.lastname: Wilms
authors.affiliation: Department of Obstetrics & Gynecology, Academic Medical Center, Amsterdam, Netherlands.
authors.forename: Gert-Jan
authors.initials: GJ
authors.lastname: van Baaren
authors.affiliation: Department of Clinical Chemistry & Haematology, University Medical Centre Utrecht, Utrecht, Netherlands.
authors.forename: Jolande Y
authors.initials: JY
authors.lastname: Vis
authors.affiliation: Department of Obstetrics & Gynecology, University Medical Center Utrecht, Utrecht, Netherlands.
authors.forename: Martijn A
authors.initials: MA
authors.lastname: Oudijk
authors.affiliation: Department of Obstetrics & Gynecology, University Medical Center Utrecht, Utrecht, Netherlands.
authors.forename: Anneke
authors.initials: A
authors.lastname: Kwee
authors.affiliation: Department of Obstetrics & Gynecology, Maxima Medical Center, Veldhoven, Netherlands.
authors.forename: Martina M
authors.initials: MM
authors.lastname: Porath
authors.affiliation: Department of Obstetrics & Gynecology, Maastricht University Medical Center, Maastricht, Netherlands.
authors.forename: Hubertina C J
authors.initials: HC
authors.lastname: Scheepers
authors.affiliation: Department of Obstetrics & Gynecology, Maastricht University Medical Center, Maastricht, Netherlands.
authors.forename: Marc E A
authors.initials: ME
authors.lastname: Spaanderman
authors.affiliation: Department of Obstetrics & Gynecology, Leiden University Medical Center, Leiden, Netherlands.
authors.forename: Kitty W M
authors.initials: KW
authors.lastname: Bloemenkamp
authors.affiliation: Department of Obstetrics & Gynecology, VU University Medical Center, Amsterdam, Netherlands.
authors.forename: Antoinette C
authors.initials: AC
authors.lastname: Bolte
authors.affiliation: Department of Obstetrics & Gynecology, VU University Medical Center, Amsterdam, Netherlands.
authors.forename: Caroline J
authors.initials: CJ
authors.lastname: Bax
authors.affiliation: Department of Obstetrics & Gynecology, Erasmus University Medical Center, Rotterdam, Netherlands.
authors.forename: Jérôme M J
authors.initials: JM
authors.lastname: Cornette
authors.affiliation: Department of Obstetrics & Gynecology, Erasmus University Medical Center, Rotterdam, Netherlands.
authors.forename: Johannes J
authors.initials: JJ
authors.lastname: Duvekot
authors.affiliation: Department of Obstetrics & Gynecology, Isala Clinics, Zwolle, Netherlands.
authors.forename: Bas W A
authors.initials: BW
authors.lastname: Nij Bijvank
authors.affiliation: Department of Obstetrics & Gynecology, Isala Clinics, Zwolle, Netherlands.
authors.forename: Jim
authors.initials: J
authors.lastname: van Eyck
authors.affiliation: Department of Obstetrics & Gynecology, University Medical Center Groningen, Groningen, Netherlands.
authors.forename: Maureen T M
authors.initials: MT
authors.lastname: Franssen
authors.affiliation: Department of Obstetrics & Gynecology, University Medical Center Groningen, Groningen, Netherlands.
authors.forename: Krystyna M
authors.initials: KM
authors.lastname: Sollie
authors.affiliation: Department of Obstetrics & Gynecology, Radboud University Hospital Nijmegen, Nijmegen, Netherlands.
authors.forename: Frank P H A
authors.initials: FP
authors.lastname: Vandenbussche
authors.affiliation: Department of Obstetrics & Gynecology, Radboud University Hospital Nijmegen, Nijmegen, Netherlands.
authors.forename: Mallory D
authors.initials: MD
authors.lastname: Woiski
authors.affiliation: Department of Obstetrics & Gynecology, Academic Medical Center, Amsterdam, Netherlands.
authors.forename: Joris A M
authors.initials: JA
authors.lastname: van der Post
authors.affiliation: Clinical Research Unit, Academic Medical Center, Amsterdam, Netherlands.
authors.forename: Patrick M M
authors.initials: PM
authors.lastname: Bossuyt
authors.affiliation: Clinical Research Unit, Academic Medical Center, Amsterdam, Netherlands.
authors.forename: Brent C
authors.initials: BC
authors.lastname: Opmeer
authors.affiliation: The Robinson Institute, School of Paediatrics and Reproductive Health, University of Adelaide, Australia.
authors.forename: Ben W J
authors.initials: BW
authors.lastname: Mol
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D000328:Adult; D054791:Cervical Length Measurement; D011307:Drug Prescriptions; D005260:Female; D005353:Fibronectins / Q000032:analysis*; D005865:Gestational Age; D006801:Humans; D007752:Obstetric Labor, Premature / Q000188:drug therapy*; D010818:Practice Patterns, Physicians'; D011247:Pregnancy; D047928:Premature Birth / Q000188:drug therapy*; D011295:Prenatal Care; D011446:Prospective Studies; D013997:Time Factors; D055815:Young Adult
chemical_list: D000305:Adrenal Cortex Hormones; D005353:Fibronectins
keywords: Antenatal corticosteroids; Cervical length; Fetal fibronectin; Preterm labor