{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T10:34:57Z","timestamp":1787135697027,"version":"build-2736575974"},"reference-count":32,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2022,6,7]],"date-time":"2022-06-07T00:00:00Z","timestamp":1654560000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100009633","name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development","doi-asserted-by":"publisher","award":["UG1 HD034216"],"award-info":[{"award-number":["UG1 HD034216"]}],"id":[{"id":"10.13039\/100009633","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2022,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To test the hypothesis that potential missed opportunities for antenatal corticosteroids increase as gestational age decreases and are associated with adverse outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Observational cohort study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Twenty\u2010four <jats:styled-content style=\"fixed-case\">US<\/jats:styled-content> centers in the Neonatal Research Network.<\/jats:p><\/jats:sec><jats:sec><jats:title>Population<\/jats:title><jats:p>Actively treated infants at 22\u201325\u2009weeks of gestation and with birthweight 401\u20131000\u2009g, without major birth defects, born 2006\u201318.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Potential missed opportunity was defined as no antenatal corticosteroids but did have prenatal antibiotics, and\/or magnesium sulphate, and\/or prolonged rupture of membranes. Poisson regression models adjusted for baseline characteristics.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measures<\/jats:title><jats:p>Antenatal corticosteroid exposure, mortality and severe intracranial haemorrhage or periventricular leucomalacia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 6966 (87.5%) infants were exposed to antenatal corticosteroids, 454 (5.7%) had no exposure but potential missed opportunities for antenatal corticosteroid exposure, and 537 (6.7%) had no exposure and no evidence of potential missed opportunities. Compared with infants born at 25\u2009weeks, potential missed opportunities for antenatal corticosteroid exposure were more likely at 22\u2009weeks (adjusted relative risk [aRR] 11.06, 95% confidence interval [CI] 7.52\u201316.27) and 23\u2009weeks (aRR 3.24, 95% CI 2.44\u20134.29) but did not differ at 24\u2009weeks (aRR 1.08, 95% CI 0.82\u20131.42). Potential missed opportunities for antenatal corticosteroids decreased over time at 22\u201323\u2009weeks of gestation. Antenatal\u2010corticosteroid\u2010exposed infants had lower risk of death (31.0% versus 54.8%; aRR 0.77, 95% CI 0.70\u20130.84) and survivors had lower risk of severe brain injury (25.0% versus 44.5%; aRR 0.64, 95% CI 0.55\u20130.73) compared with infants with potential missed opportunities.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Potential missed opportunities for antenatal corticosteroid exposure increased with decreasing gestational age and were associated with higher rates of death and severe brain injury among actively treated periviable births.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1471-0528.17230","type":"journal-article","created":{"date-parts":[[2022,5,25]],"date-time":"2022-05-25T02:36:35Z","timestamp":1653446195000},"page":"2039-2051","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Potential missed opportunities for antenatal corticosteroid exposure and outcomes among periviable births: Observational cohort study"],"prefix":"10.1111","volume":"129","author":[{"given":"Colm P.","family":"Travers","sequence":"first","affiliation":[{"name":"Pediatrics University of Alabama at Birmingham  Birmingham Alabama USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nellie I.","family":"Hansen","sequence":"additional","affiliation":[{"name":"Social, Statistical and Environmental Sciences Unit RTI International  Research Triangle Park North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abhik","family":"Das","sequence":"additional","affiliation":[{"name":"Social, Statistical and Environmental Sciences Unit RTI International  Rockville Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew A.","family":"Rysavy","sequence":"additional","affiliation":[{"name":"Pediatrics University of Iowa  Iowa City Iowa USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward F.","family":"Bell","sequence":"additional","affiliation":[{"name":"Pediatrics University of Iowa  Iowa City Iowa USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Namasivayam","family":"Ambalavanan","sequence":"additional","affiliation":[{"name":"Pediatrics University of Alabama at Birmingham  Birmingham Alabama USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Myriam","family":"Peralta\u2010Carcelen","sequence":"additional","affiliation":[{"name":"Pediatrics University of Alabama at Birmingham  Birmingham Alabama USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alan T.","family":"Tita","sequence":"additional","affiliation":[{"name":"Obstetrics &amp; 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