Timing of Antenatal Corticosteroids for Optimal Neonatal Outcomes: A Markov Decision Analysis Model

Society for Maternal-Fetal Medicine Special Statement: Quality metrics for optimal timing of antenatal corticosteroid administration

“…Although it seems intuitive that there should be a lower threshold for administering antenatal corticosteroid at extremely early gestational ages, statistical modeling suggests that the optimal strategy depends on complex interactions of many variables, including the indication for preterm birth and the gestational ageespecific probabilities of reducing perinatal death and severe neonatal morbidity. 54 Improved risk prediction would not only facilitate improved timing of antenatal corticosteroid administration but also enhance our overall understanding of the epidemiology and pathophysiology of preterm birth. Thus, to improve our BOX Five possible scenarios of antenatal corticosteroid administration before early preterm birth (<34 weeks of gestation)…”

Understanding what patients and physicians need to improve their decision-making about antenatal corticosteroids in late preterm gestation: a qualitative framework analysis

“…Previous quantitative studies for decision-making for antenatal corticosteroids have included a Markov decision analysis model to optimize timing of antenatal corticosteroids (i.e., immediate v. delayed administration after deciding that treatment is warranted), 24 and a decision tree model to assess administration of antenatal corticosteroids in the context of maternal infection with SARS-CoV-2. 25 Our use of semistructured interviews and framework analysis with patients, obstetricians and pediatricians allowed us to explore diverse perspectives and ensure participants understood the decision problem, while still effectively answering the main study questions.…”