Background: Repeat prenatal corticosteroids have been in common use worldwide, even though the National Institutes of Health recommends that 'Until data establish a favourable benefit-to-risk ratio, repeat courses of antenatal corticosteroids, including rescue therapy, should be reserved for patients enrolled in clinical trials.'
Objectives: To describe the current use/recommendations for the use of repeat prenatal corticosteroids by obstetricians and neonatologists and to examine the sources of evidence on which their practice is based.
Design: Postal questionnaire.
Population: All Trainees, Members and Fellows of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists and neonatologists in Australia and New Zealand.
Methods: The questionnaire was mailed to obstetricians and neonatologists in August-September 2001.
Main Outcome Measures: Practitioner use/recommendations for the use of repeat prenatal corticosteroids and the sources of evidence on which their practice was based.
Results: Use of repeat prenatal corticosteroids was recommended by 332 (44%) obstetricians and 19 (21%) neonatologists. Obstetricians were twice as likely to recommend their use compared with neonatologists (relative risk, 2.04; 95% confidence intervals, 1.36-3.06; P < 0.001). Over half of the respondents (483, 57%) reported they had changed their use/recommendations in the previous 3 years. The sources of evidence behind these practices differed between obstetricians and neonatologists and between those practitioners who recommended the use of repeat prenatal corticosteroids and those who did not.
Conclusions: Fewer practitioners recommend repeat prenatal corticosteroids compared with previous surveys. Sources of evidence behind the practice of groups of obstetricians and neonatologists differ.
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