An evaluation of antenatal corticosteroid use and timing in a large US birth cohort 2017-2021.

Introduction: There is a lack of published data on the contemporary use and timing of antenatal corticosteroids in the United States. Our primary objective was to address this gap using clinical data from a large US birth cohort. Our secondary objective was to identify factors associated with optimally timed steroids in births <34 weeks' gestation. Methods: This retrospective study included de-identified clinical data from a quality improvement database for births at 24 Results: Of 105,981 patients included in the analysis, 6.1% (6443) received steroids before 37 weeks' gestation. A total of 83.1% of live births <34 weeks' gestation received antenatal steroids, but only 55.4% received optimally timed steroids. The rate of optimally timed steroids in births <34 weeks' gestation was stable between 2017 and 2021. Over the same period, the proportion of births at 34 Conclusion: In our study, most patients who delivered at <34 weeks' gestation received at least one dose of antenatal corticosteroids, but this was outside of the optimal 7-day window in approximately half of cases. Quality improvement efforts should focus on timing, as well as the use of antenatal corticosteroids.