Antenatal corticosteroids in pregnancies complicated by preterm premature rupture of membranes

Obstet Gynecol. 1997 Nov;90(5):851-3. doi: 10.1016/S0029-7844(97)00404-3.

Abstract

In 1994, the National Institutes of Health Consensus Development Conference on Antenatal Steroids recommended corticosteroids between 24 and 30-32 weeks' gestation in pregnancies complicated by preterm premature rupture of membranes (PROM). Since the Consensus Conference, the use of antenatal corticosteroids has increased to approximately 60% of potential treatment candidates. Some of the remaining 40% of pregnant candidates may go untreated because of concern that corticosteroids could increase the risk of neonatal infection. Using decision-analysis techniques, we compared the potential benefit of antenatal corticosteroids in reducing the incidence of severe intraventricular hemorrhage with the potential risk of increasing the rate of neonatal sepsis. Our analysis indicates that the benefit of a small decrease in severe intraventricular hemorrhage outweighs the potential harm of a large increase in the rate of neonatal sepsis. Therefore, we support the Consensus Conference panel's recommendation that antenatal corticosteroids be used in pregnancies complicated by preterm PROM.

Publication types

  • Comparative Study

MeSH terms

  • Adrenal Cortex Hormones / therapeutic use*
  • Cerebral Hemorrhage / epidemiology
  • Cerebral Hemorrhage / prevention & control
  • Consensus Development Conferences, NIH as Topic
  • Decision Support Techniques
  • Female
  • Fetal Membranes, Premature Rupture* / complications
  • Fetal Membranes, Premature Rupture* / drug therapy
  • Humans
  • Infant, Newborn
  • Infant, Premature, Diseases / chemically induced
  • Infant, Premature, Diseases / epidemiology
  • Infant, Premature, Diseases / prevention & control*
  • Pregnancy
  • Risk Factors
  • Sepsis / chemically induced
  • Sepsis / epidemiology
  • United States

Substances

  • Adrenal Cortex Hormones