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Antenatal Corticosteroid Use Up, Even When Not Optimal

From 1988 to 2012, increase in optimal, suboptimal, and questionably appropriate use

WEDNESDAY, Jan. 14, 2015 (HealthDay News) -- From 1988 to 2012, there were increases in the rates of optimal, suboptimal, and questionably appropriate administration of antenatal corticosteroids, according to a study published online Jan. 7 in Obstetrics & Gynecology.

Neda Razaz, M.P.H., from the University of British Columbia in Vancouver, Canada, and colleagues conducted a population-based study involving all 246,459 live births in Nova Scotia, Canada, from 1988 to 2012 to examine rates of administration of antenatal corticosteroids. The authors quantified temporal trends in optimal, suboptimal, and questionably appropriate exposure to antenatal corticosteroids.

The researchers found that for neonates born between 28 and 32 weeks of gestation, there was an increase in the rate of antenatal corticosteroid exposure, from 39.5 percent in 1988-1992 to 79.3 percent in 2008-2012. For those born at 33 to 34 weeks, exposure increased from 14.3 to 49.7 percent. There was an increase in receipt of antenatal corticosteroids in optimal cases (from 10 percent in 1988 to 23 percent in 2012; odds ratio, 2.7); suboptimal cases (from 7 to 34 percent; odds ratio, 6.7), and questionably appropriate cases (from 0.2 to 1.7 percent; odds ratio, 7.5).

"Temporal increases in optimal exposure to antenatal corticosteroids have been matched by increases in suboptimal and questionably appropriate receipt of antenatal corticosteroids, highlighting the need for accurate preterm delivery prognostic models," the authors write.

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