Obstetrical attitudes to glucocorticoid treatment for fetal lung maturation: time for a change?

A questionnaire survey was conducted among 1004 specialist and trainee obstetricians in the Netherlands and northern Belgium (i.e., Flanders). Glucocorticoids would be used by 85% in Belgium and 74% in the Netherlands, while 59% in both countries would combine them with betamimetic drugs in preterm labor. The more frequently respondents relied on glucocorticoids, the more likely they were to use them at more advanced gestational ages, to combine them with betamimetic drugs and to use that combination beyond 34 wk. Of those using glucocorticoids, only 11% would not do so after 32 wk, while 37% would use them after 34 wk and 5% even beyond 36 wk of gestation. Gestational age limits did not differ for glucocorticoids with or without betamimetic drugs. The findings indicate that the encouraging results of the early trials have lead to widespread inappropriate use of prenatal glucocorticoid therapy. Substantial overuse was more frequent than rejection of its use.