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FIGO good practice recommendations on the use of prenatal corticosteroids to improve outcomes and minimize harm in babies born preterm

Research output: Contribution to journalArticlepeer-review

the FIGO Working Group for Preterm Birth

Original languageEnglish
Pages (from-to)26-30
Number of pages5
JournalInternational Journal of Gynecology and Obstetrics
Volume155
Issue number1
DOIs
PublishedOct 2021

Bibliographical note

Funding Information: Jane Norman reports receipt of grants from government and charitable bodies for research into understanding the mechanism of term and preterm labour and understanding treatments; participation in a Data Safety and Monitoring Board for a study involving a preterm birth therapeutic agent for GlaxoSmithKline; and consultancy for Dilafor on drugs to alter labour progress. Andrew Shennan reports payment/honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from Manipal India; support for attending meetings and/or travel from Hologic; leadership or fiduciary roles in the HTA Commissioning Board UK and Action on Pre‐eclampsia charity. Lisa Story reports receipt of equipment, materials, drugs, medical writing, gifts or other services from Clinical Innovations. Bo Jacobbson reports research grants from Swedish Research Council, Norwegian Research Council, March of Dimes, Burroughs Wellcome Fund and the US National Institute of Health; clinical diagnostic trials on NIPT with Ariosa (completed), Natera (ongoing), Vanadis (completed) and Hologic (ongoing) with expendidures reimbused per patient; clinical probiotic studies with product provided by FukoPharma (ongoing, no funding) and BioGaia (ongoing; also provided a research grant for the specific study); collaboration in IMPACT study where Roche, Perkin Elmer and Thermo Fisher provided reagents to PLGF analyses; coordination of scientific conferences and meetings with commercial partners as such as NNFM 2015, ESPBC 2016 and a Nordic educational meeting about NIPT and preeclampsia screening. Bo Jacobbson is also Chair of the FIGO Working Group for Preterm Birth and the European Association of Perinatal Medicine's special interest group of preterm delivery; steering group member of Genomic Medicine Sweden; chairs the Genomic Medicine Sweden complex diseases group; and is Swedish representative in the Nordic Society of Precision Medicine. Sarah J. Stock reports research funding from NIHR, Wellcome Trust, Chief Scientist Office Scotland, Tommy's, and Medical Research Council; participation on a Data Safety Monitoring Board or Advisory Board for NIHR‐funded WILL trial and NIHR‐funded Giant Panda; leadership or fiduciary roles for SANDS and RCOG Stillbirth Clinical Studies Group; and receipt of equipment, materials or drugs from Hologic, Medix Biochemica, and Parsogen Diagnostics. Funding Information: This work has been supported by grants from March of Dimes. Publisher Copyright: © 2021 The Authors. International Journal of Gynecology & Obstetrics published by John Wiley & Sons Ltd on behalf of International Federation of Gynecology and Obstetrics. Copyright: Copyright 2021 Elsevier B.V., All rights reserved.

King's Authors

Abstract

For women with a singleton or a multiple pregnancy in situations where active neonatal care is appropriate, and for whom preterm birth is anticipated between 24 and 34 weeks of gestation, one course of prenatal corticosteroids should ideally be offered 18 to 72 h before preterm birth is expected to improve outcomes for the baby. However, if preterm birth is expected within 18 h, prenatal corticosteroids should still be administered. One course of corticosteroids includes two doses of betamethasone acetate/phosphate 12 mg IM 24 h apart, or two doses of dexamethasone phosphate 12 mg IM 24 h apart. In women in whom preterm birth is expected within 72 h and who have had one course of corticosteroids more than a week previously, one single additional course of prenatal corticosteroids could be given at risk of imminent delivery. Prenatal corticosteroids should not be offered routinely to women in whom late preterm birth between 34 and 36 weeks is anticipated. In addition, prenatal corticosteroids should not be given routinely before cesarean delivery at term. Neither should prenatal corticosteroids be given “just in case”. Instead, prenatal steroid administration should be reserved for women for whom preterm birth is expected within no more than 7 days, based on the woman's symptoms or an accurate predictive test.

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