P12
PRENATAL CORTICOSTEROID PRESCRIBING: CURRENT PRACTICE IN SOUTH AUSTRALIA
Crowther C, Vigneswaran P, Willson K
Maternal and Perinatal Clinical Trials Unit, Departments of Obstetrics and Gynaecology and Public
Health, University of Adelaide
Background: A single course of prenatal corticosteroids administered to women at risk of preterm birth
reduces the likelihood of respiratory distress syndrome from 40% to 21% in babies born before 32 weeks
gestation (Crowley 1997). However, the incorporation of prenatal corticosteroids into routine care has been
slow. A formal survey of practice allows assessment of current prescribing habits, exploration of indications and
settings expected to be used, and information that could be helpful to improve appropriate prescribing.
Aims: To survey practising obstetricians in South Australia and assess their current pattern of prescribing
prenatal corticosteroids and willingness to be involved in a randomised trial of repeat doses of prenatal
corticosteroids.
Methods: A postal questionnaire was sent to the 117 Trainees, Members and Fellows of the Royal Australian
College of Obstetricians and Gynaecologists (RACOG) registered in South Australia. The 15 questions were
concerned with the type of corticosteroids used, timing of administration, indications for use, whether repeat
doses of prenatal steroids were prescribed and willingness to participate in a randomised placebo blinded trial of
repeat doses of steroids. The data were collated and descriptive statistics performed.
Results: Of the 81 practitioners currently practising obstetrics at the time of the survey distribution, 44
(54.3%) completed and returned the questionnaire. Of these respondents, 6 (13.6%) were Trainees, 2 (4.5%)
were Members and 36 (81.8%) were Fellows of the RACOG. When asked how long they had been in obstetric
practice: 24 (54.5%) had been practising for  10 years; 13 (29.5%) had been practising for  20 years; 5
(11.4%) had been practising for  30 years; 1 (2.3%) had been practising for > 30 years and 1 (2.3%) did not
respond to the question.
PRESCRIBING PRACTICES FOR PRENATAL CORTICOSTEROIDS
n=44
Currently prescribe prenatal corticosteroids
44
Betamethasone
43
Dexamethasone
1
Currently prescribe repeat doses of prenatal corticosteroids
32
Willing to participate in a randomised placebo controlled trial
26
not willing to participate in a randomised placebo controlled trial
3
Unsure if willing to participate in a randomised placebo controlled trial 3
Values are number (%) practitioners.
(n%)
100
97.7
2.3
72.7
81.3
9.4
9.4
Both single and repeat doses of steroids were used for all the most frequent reasons for preterm birth.
Conclusions: 100% of the survey respondents administer prenatal corticosteroids to women at risk of preterm
birth suggesting this is the current standard practice in South Australia. Betamethasone is the preferred drug for
treatment. There is a widespread tendency to continue treatment after 7 days or more with repeat doses of
corticosteroids. The majority of practitioners stated a willingness to be involved in a randomised controlled trial
of repeat doses of steroids