The Utilization of Antenatal Late Preterm Steroids at a Tertiary Care Academic Medical Center [24I]

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Abstract

INTRODUCTION:

The purpose of this study was to examine the utilization of antenatal late preterm steroids (ALPS) at a single institution following publication of recent evidence suggesting neonatal benefits in the late preterm period.

METHODS:

A retrospective cohort study was performed including all patients with singleton gestations at 34 weeks to 36 weeks 5 days admitted from April 2016 through March 2017.

RESULTS:

During the study period, 102 patients met inclusion criteria. A total of 28 patients (27.5%) received ALPS. Of the entire cohort, 35 (34.3%) patients qualified for ALPS administration. Of these 35 qualifying patients, 21 (60%) received steroids and 14 (40%) did not. Seven (6.9%) patients received steroids and did not meet standard ALPS criteria. Maternal demographic characteristics and indications for admission were similar between groups. Women who received ALPS were admitted at an earlier median gestational age than women not given ALPS (p<0.005). Common contraindications to steroid administration were delivery anticipated in <12 hours (19.6%), pre-gestational diabetes (11.8%), prior steroid administration <34 weeks (11.8%), and gestational diabetes (6.9%). There were no differences in the rate of NICU admission or neonatal length of stay between groups. The rate of NICU admission in the entire cohort was 43.1% (44/102).

CONCLUSION:

One-third of patients admitted in the late preterm period met criteria for administration of ALPS. Only 60% of patients who qualified for ALPS received steroids. The rate of NICU admission in the late preterm period remains high. Increasing the appropriate use of ALPS may help to further improve neonatal outcomes in this population.

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