title: [Evaluation of corticosteroid administration in situations of suspected imminent preterm delivery: a retrospective cohort study in a tertiary centre].
abstract: OBJECTIVE
  The administration of a single-course antenatal corticosteroid treatment is recommended for pregnant women between 24 and 34 weeks with risk of premature birth. The maximum effect is achieved when antenatal corticosteroids are administered between 24h and 7 days before delivery. The objective of this study was to evaluate the occurrence of birth within seven days of corticosteroid therapy in major obstetric situations with risk of preterm birth.
  
  
  METHODS
  Retrospective cohort study including 209 pregnant women hospitalized in risk of preterm delivery, submitted to corticosteroid therapy for fetal lung maturation. The study was carried out between January 2012 and March 2014 at a university hospital. Main outcome measure was the number of women who delivered within 7 da ys after antenatal corticosteroid administration. Two groups were defined according to the reason for starting corticosteroids: threatened preterm labour (Group APPT) and other indications for corticosteroid therapy (Group RPPT). A Kaplan-Meier survival analysis was performed and a p value <0.05 was considered statistically significant.
  
  
  RESULTS
  46.4% (n=97) of pregnant women gave birth in the seven days following corticosteroid administration. Delivery within 7 days occurred more frequently on group 2 in comparison to group 1 (57.3 versus 42.4%; p=0.001). There is a statistically significant difference between the survival curve for groups 1 and 2, with a hazard ratio for delivery within 7 days 1.71 times higher for group 2 (95%CI 1.23-2.37; p<0.001).
  
  
  CONCLUSIONS
  It can be concluded that the probability of an event (birth within 7 days after corticosteroids) is smaller in the group of pregnant women admitted in the context of threatened preterm labor than for other indications. The use of corticosteroids in pregnant women admitted for suspected preterm labor should be subject to rigorous clinical evaluation.
authors.affiliation: Centro Hospitalar S. João, Porto, Portugal.
authors.forename: Pedro Filipe Viana Ferreira
authors.initials: PF
authors.lastname: Pinto
authors.affiliation: Universidade do Porto, Porto, Portugal.
authors.forename: Tiago José Santos Matos
authors.initials: TJ
authors.lastname: Ferraz
authors.affiliation: Universidade do Porto, Porto, Portugal.
authors.forename: Carla Maria Almeida
authors.initials: CM
authors.lastname: Ramalho
authors.affiliation: Universidade do Porto, Porto, Portugal.
authors.forename: Nuno Aires Mota de Mendonça
authors.initials: NA
authors.lastname: Montenegro
mesh_terms: D000328:Adult; D001623:Betamethasone / Q000627:therapeutic use*; D015331:Cohort Studies; D003907:Dexamethasone / Q000627:therapeutic use*; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D053208:Kaplan-Meier Estimate; D036801:Parturition; D011247:Pregnancy; D047928:Premature Birth / Q000517:prevention & control*; D012189:Retrospective Studies; D062606:Tertiary Care Centers
chemical_list: D005938:Glucocorticoids; D003907:Dexamethasone; D001623:Betamethasone