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.
KEYWORDS
Antenatal corticosteroids - preterm delivery
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Jolande Y VisM.D. M.Sc.
Department of Obstetrics and Gynaecology, Academic Medical Center
P.O. Box 22660, 1100 DD Amsterdam, The Netherlands
Email: jolandevis@gmail.com
