Trends in receipt of single and repeat courses of antenatal corticosteroid administration among preterm and term births: A retrospective cohort study

Grzeskowiak, Luke E.; Grivell, Rosalie M; Mol, Ben Willem J.

doi:10.1111/ajo.12657

Cited by 13 publications

(8 citation statements)

References 19 publications

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“…Almost all women with DIP giving birth before 35 weeks' gestation received at least one course of ANC and more than one half of women who received ANC received them within 7 days of birth. These rates are consistent with or greater than those reported for cohorts of women from the general population by the Australian and New Zealand Neonatal Network [29], the Canadian Perinatal Network [30] and other large tertiary level units [5,27].…”

Section: Discussionsupporting

confidence: 87%

“…Women with pre-existing diabetes [4] and gestational diabetes [4,5] are more likely than women without diabetes to receive ANC, but it is not clear if this is due to the increased rate of preterm birth in women with DIP [6,7] or because their infants are more likely to develop complications of preterm birth [8], or both.…”

Section: Introductionmentioning

confidence: 99%

“…The Australian and New Zealand ANC guidelines do not recommend the use of ANC after 35 weeks' gestation or prior to elective caesarean section at term unless there is evidence of fetal lung immaturity [3]. However, administration of ANC in the late preterm period has increased over the last 20 years [5,16] and many practitioners in Australia and New Zealand report prescribing ANC in the late preterm and early term period prior to caesarean section [17]. Some professional bodies elsewhere recommend this practice [18] while others state that ANC administration could be considered [19], particularly in situations where infants are at greater risk of respiratory complications [20].…”

Section: Introductionmentioning

confidence: 99%

“…No adverse outcomes up to mid-childhood have been reported following repeat courses of ANC compared to a single course [21]. Despite the demonstrated benefit of repeat courses of ANC, ongoing concern regarding potential adverse effects is reflected in the declining rates of repeat courses of ANC reported over the last 5 years [5,22,23].…”

Section: Introductionmentioning

confidence: 99%

“…Although DIP is a common medical complication in pregnancy, affecting 9% of women in New Zealand [24], there are few data regarding current practice for ANC administration in these women, who comprise a small percentage of all women who receive ANC, and types of diabetes are seldom differentiated [5,[25][26][27].…”

Section: Introductionmentioning

confidence: 99%

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Patterns of antenatal corticosteroid administration in a cohort of women with diabetes in pregnancy

et al. 2020

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Antenatal corticosteroids administered to the mother prior to birth decrease the risk of mortality and major morbidity in infants born at less than 35 weeks' gestation. However, the evidence relating to women with diabetes in pregnancy is limited. Clinical guidelines for antenatal corticosteroid administration recommend that women with diabetes in pregnancy are treated in the same way as women without diabetes, but there are no recent descriptions of whether contemporary practice complies with this guidance. This study is a retrospective review of antenatal corticosteroid administration at a New Zealand tertiary hospital in women with diabetes in pregnancy. We found that in this cohort, for both an initial course at less than 35 weeks' gestation and repeat courses at less than 33 weeks', the administration of antenatal corticosteroid to women with diabetes in pregnancy is largely consistent with current Australian and New Zealand recommendations. However, almost 25% of women received their last dose of antenatal corticosteroid at or beyond the latest recommended gestation of 35 weeks' gestation. Pre-existing diabetes and planned caesarean section were independently associated with an increased rate of antenatal corticosteroid administration. We conclude that diabetes in pregnancy does not appear to be a deterrent to antenatal corticosteroid administration. The high rates of administration at gestations beyond recommendations, despite the lack of evidence of benefit in this group of women, highlights the need for further research into the risks and benefits of antenatal corticosteroid administration to women with diabetes in pregnancy, particularly in the late preterm and early term periods.

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Section: Discussionsupporting

confidence: 87%