Abstract
Objective The objective of this study was to measure knowledge and practice variation in late
preterm steroid use.
Study Design Electronic survey of American College of Obstetricians and Gynecologists (ACOG) members
about data supporting the ACOG/Society for Maternal-Fetal Medicine (SMFM) recommendations
and practice when caring for women with anticipated late preterm birth (PTB), 340/7 to 366/7 weeks.
Results Of 352 administered surveys, we obtained 193 completed responses (55%); 82.5% were
generalist obstetrician-gynecologists (OB/GYNs), and 42% cared for women with anticipated
late PTB at least weekly. Most believed that late preterm steroids provided benefit
by reducing respiratory distress syndrome (93%), transient tachypnea of the newborn
(83%), and neonatal intensive care unit admission (82%). More than half administered
late preterm steroids to women with multiple gestations (73%), and pregestational
diabetes (55–80%) depending on glycemic control. OB/GYNs administered steroids to
insulin-dependent and poorly controlled diabetics more often than MFMs (75 vs. 46%
and 59 vs. 37% respectively, p < 0.05 for both). While providers believed there was increased maternal hyperglycemia
(88%) and neonatal hypoglycemia (59%), 88% believed neonatal respiratory benefits
outweighed these risks. Respondents agreed research is needed to determine who are
appropriate candidates (77%) and how to minimize adverse outcomes (82%).
Conclusion Most providers are administering late preterm steroids to all women, even those populations
who have been excluded from previous trials. Despite widespread use, providers believe
more research is needed to optimize management.
Keywords
survey - late preterm - antenatal corticosteroids
