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Should the interval between doses of antenatal corticosteroids be shortened in certain cases? Factors predicting preterm delivery < 48 h from presentation

  • Maternal-Fetal Medicine
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

Treatment with antenatal corticosteroids (ACS) to women at risk for preterm birth (PTB) is associated with a reduction in adverse neonatal outcomes. Obstetricians occasionally shorten the interval between the doses of steroids if delivery is predicted to occur before ACS are fully administered. In this study, we aimed to investigate predicting factors to identify patients that will deliver prematurely, less than 48 h from presentation.

Methods

The computerized medical files of all PTBs (< 34 weeks) were reviewed. Maternal demographics, pregnancy and delivery characteristics were compared between PTB that occurred < 48 h vs. > 48 h from triage presentation.

Results

In total, 494 PTB cases were included: 302 women in the study group (PTB < 48 h) and 192 women in the control group (PTB > 48 h). No significant differences were found in demographic characteristics between the groups. At presentation, the study group had higher rates of uterine contractions (p < 0.001) and cervical length < 25 mm (p < 0.001) as well as a higher rate of non-reassuring fetal (NRFHR) monitor (p < 0.001). In contrast, the control group presented with higher rates of preeclampsia (p = 0.003) and preterm premature rupture of membranes (p = 0.038). In multivariable analysis, all of the above factors remained significant after controlling for background confounders.

Conclusions

Various factors at presentation can predict delivery < 48 h. These factors can be used to predict patients to whom the ACS interval should be shortened. Future prospective studies should investigate the effect of this shortening on neonatal outcomes.

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Data statement

Data available on request due to privacy/ethical restrictions.

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Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, The Edith Wolfson Medical Center, PO Box 5, 58100, Holon, Israel

    Hadas Miremberg, Nofar Elia, Cindy Marelly, Ohad Gluck, Giulia Barda, Jacob Bar & Eran Weiner

  2. Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel

    Hadas Miremberg, Nofar Elia, Cindy Marelly, Ohad Gluck, Giulia Barda, Jacob Bar & Eran Weiner

Authors
  1. Hadas Miremberg
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  2. Nofar Elia
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  3. Cindy Marelly
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  4. Ohad Gluck
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  5. Giulia Barda
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  6. Jacob Bar
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  7. Eran Weiner
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Contributions

HM and EW—protocol development and methodology, manuscript writing and editing. NE and CM—data collection and management. OG and GB—data analysis and management. JB—manuscript writing and editing.

Corresponding author

Correspondence to Hadas Miremberg.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This research study was conducted retrospectively from data obtained for clinical purposes. Approval was obtained from the local ethics committee (decision number 0095-20-WOMC).

Informed consent

The study was a retrospective study collecting data from computerized files. The institutional ethics committee exempted the authors from obtaining individual informed consent.

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Miremberg, H., Elia, N., Marelly, C. et al. Should the interval between doses of antenatal corticosteroids be shortened in certain cases? Factors predicting preterm delivery < 48 h from presentation. Arch Gynecol Obstet 304, 913–918 (2021). https://doi.org/10.1007/s00404-021-06032-8

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  • DOI: https://doi.org/10.1007/s00404-021-06032-8

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