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Analysis of Antenatal Corticosteroid Prophylaxis Effectiveness
Objective:
- Examine trends in effective antenatal corticosteroid prophylaxis (ACS) use for preterm birth-related diagnoses.
Methods:
- Retrospective study using delivery data at Charité Berlin, Germany from 2014 to 2020.
- Evaluate the rate of effective ACS administrations (≤10 days before delivery) and the percentage of post-ACS deliveries at or after 37 weeks.
- Investigate conditions associated with ineffective ACS administrations.
Results:
- Overall effective ACS rate: 42% (709 out of 1,672).
- Post-ACS deliveries at or after 37 weeks: 19% (343).
- Placenta previa, twin pregnancy, and isthmocervical insufficiency linked to ineffective ACS (19-34% effective).
- Increasing trend of ACS effectiveness over the study period (p=0.002).
- Improvement in ACS effectiveness for placental dysfunction and isthmocervical insufficiency diagnoses (p=0.028; p=0.001).
Conclusions:
- Decrease in post-ACS deliveries at or after 37 weeks compared to previous findings (19% vs. 27%).
- Frequent ineffective ACS administrations in patients with specific conditions.
- Potential for new diagnostic tools to enhance ACS effectiveness.
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