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Description
The administration of corticosteroids in the late-preterm period (34 to 36+6 weeks' gestation) remains a topic of ongoing debate. The landmark Antenatal Late Preterm Steroids (ALPS) trial demonstrated a significant reduction in neonatal respiratory morbidity with the use of late-preterm corticosteroids, leading to updated recommendations by the Society of Maternal-Fetal Medicine in August 2016 supporting their administration for patients at risk of late-preterm delivery. Given that late-preterm births accounted for 7.4% of live births in the United States in 2020, optimizing neonatal outcomes in this population is a critical public health concern.
Antenatal corticosteroid administration between 24 and 33+6 weeks' gestation is an established standard of care, following evidence from the pioneering study by Liggins and Howie (1972) that demonstrated reductions in respiratory distress syndrome (RDS) and neonatal mortality. However, extending this practice to the latepreterm period has generated controversy, with conflicting study results. While the ALPS trial found improved neonatal respiratory outcomes, other studies, such as those by Porto et al., found no significant differences in respiratory morbidity between treated and untreated groups. Additionally, concerns remain regarding long-term effects and appropriate patient selection criteria for late-preterm corticosteroid administration.
Given these uncertainties, our study aims to report on the use of late-preterm corticosteroids and to evaluate primary neonatal and secondary maternal health outcomes following the implementation of a latepreterm corticosteroid protocol at our institution. Our study is limited to births before December 2019 to minimize confounding effects from the COVID-19 pandemic. Evaluating compliance and understanding the real-world impact of this protocol will contribute to the ongoing discussion regarding the benefits and potential risks of late-preterm corticosteroid use.
Publication Date
5-2025
Keywords
corticosteroids, late-preterm period
Disciplines
Obstetrics and Gynecology
Recommended Citation
O’Mara S, Jaber S, Wharton K. The administration of antenatal corticosteroids in the late-preterm period. Poster presented at: Oakland University William Beaumont School of Medicine Embark Capstone Colloquium; 2025 May; Rochester Hills, MI.
Comments
The Embark Capstone Colloquium at the Oakland University William Beaumont School of Medicine, Rochester Hills, MI, May, 2025.