{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T12:08:04Z","timestamp":1784290084832,"version":"3.55.0"},"reference-count":28,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T00:00:00Z","timestamp":1775520000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T00:00:00Z","timestamp":1775520000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100000265","name":"Medical Research Council","doi-asserted-by":"publisher","award":["MC_UU_00022\/5"],"award-info":[{"award-number":["MC_UU_00022\/5"]}],"id":[{"id":"10.13039\/501100000265","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pregnancy"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>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\u00a0&lt;34 weeks\u2019 gestation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This retrospective study included de\u2010identified clinical data from a quality improvement database for births at 24\n                      <jats:sup>+0<\/jats:sup>\n                      \u201342\n                      <jats:sup>+6<\/jats:sup>\n                      weeks\u2019 gestation between January 1, 2017 and December 31, 2021 at 12 hospitals in the northwest United States. We evaluated the proportion of live births\u00a0&lt;34 weeks\u2019 gestation that received at least a first dose of antenatal steroids within the 7 days preceding birth (\u201coptimally timed\u201d steroids), and the proportion of patients given antenatal steroids who delivered at term. Annual rates of these measures were also evaluated across the study period. Associations between optimal steroid timing in preterm births\u00a0&lt;34 weeks\u2019 gestation and sociodemographic and medical characteristics were explored with a multilevel logistic regression model using hospitals as random effects.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 105,981 patients included in the analysis, 6.1% (6443) received steroids before 37 weeks\u2019 gestation. A total of 83.1% of live births\u00a0&lt;34 weeks\u2019 gestation received antenatal steroids, but only 55.4% received optimally timed steroids. The rate of optimally timed steroids in births\u00a0&lt;34 weeks\u2019 gestation was stable between 2017 and 2021. Over the same period, the proportion of births at 34\n                      <jats:sup>+0<\/jats:sup>\n                      \u201336\n                      <jats:sup>+6<\/jats:sup>\n                      weeks\u2019 gestation that received steroids increased from 36.6% to 46.6%, and the proportion that received steroids and then delivered at term increased from 15.5% to 22.1% (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.001). After adjusting for confounders, preeclampsia was associated with increased odds for optimally timed steroids in births\u00a0&lt;34 weeks\u2019 gestation (OR 1.46; 95% CI 1.20, 1.79) while ruptured membranes (odds ratio [OR], 0.76; 95% CI, 0.63, 0.91) and placenta previa (OR, 0.28; 95% CI, 0.16, 0.51) were associated with decreased odds.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In our study, most patients who delivered at\u00a0&lt;34 weeks\u2019 gestation received at least one dose of antenatal corticosteroids, but this was outside of the optimal 7\u2010day window in approximately half of cases. Quality improvement efforts should focus on timing, as well as the use of antenatal corticosteroids.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/pmf2.70287","type":"journal-article","created":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T16:04:59Z","timestamp":1775577899000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["An evaluation of antenatal corticosteroid use and timing in a large US birth cohort 2017\u20132021"],"prefix":"10.1002","volume":"2","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5599-8179","authenticated-orcid":false,"given":"Vivienne","family":"Souter","sequence":"first","affiliation":[{"name":"Obstetrical Care Outcomes Assessment Program (OB COAP) Foundation for Health Care Quality Seattle Washington USA"},{"name":"Public Health, School of Health and Wellbeing University of Glasgow  Glasgow Scotland UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5571-9579","authenticated-orcid":false,"given":"C. 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&amp; Obstetrics Uniformed Services University Bethesda Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9497-8904","authenticated-orcid":false,"given":"Sarah M.","family":"Edwards","sequence":"additional","affiliation":[{"name":"CommonSpirit Southern Colorado Maternal Fetal Medicine  Colorado Springs Colorado USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2802-7670","authenticated-orcid":false,"given":"Asma","family":"Khalil","sequence":"additional","affiliation":[{"name":"Vascular Biology Research Centre Molecular and Clinical Sciences Research Institute City St George's University of London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7170-1205","authenticated-orcid":false,"given":"Andreas","family":"Hoehn","sequence":"additional","affiliation":[{"name":"Public Health, School of Health and Wellbeing University 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