In the United States, approximately 12% of all live births occur preterm- before 37 weeks of pregnancy. Preterm labor precedes about 50% of these preterm births. Although the causes of preterm labor are not well understood, the burden of preterm births is clear- preterm births account for approximately 70% of neonatal deaths and 36% of infant deaths as well as 25-50% of cases of long-term neurologic impairment in children.
Identifying women who will give birth preterm is imprecise, and there is no medication which is clearly associated with the prevention of preterm birth. The medications which have been shown to improve neonatal outcomes with preterm infants are magnesium sulfate for neuroprotection and antenatal corticosteroids for maturation of fetal lungs and protection of other organ systems.
A single course of corticosteroids is recommended for pregnant women between 24 and 34 weeks of gestation who are at risk of preterm delivery within seven days. This course of steroids is given in the hospital over 1-2 days. We advise our patients that if they are having preterm contractions less than 10 minutes apart or think that the bag of water might be leaking or ruptured to go immediately to the hospital for evaluation. If it is determined that you are in preterm labor, or your membranes have ruptured, we should be contacted by the hospital personnel to give orders and management instructions. The most recent literature seems to indicate that late preterm infants also benefit from a course of antenatal steroids between 34- 36 weeks approximately.
Dr. Walker and Dr. Shakespeare have always understood the importance of administering antenatal steroids to patients who are threatening to deliver between 24 and 34 weeks and will ensure that you receive this important therapeutic measure for the health and benefit of your baby.