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Obstetrician-Gynecologists’ Knowledge and Training About Antenatal Corticosteroids

From the American College of Obstetricians and Gynecologists, Washington, DC; Mcmaster University, Department of Psychology, Hamilton, Ontario, Canada; and Cedars-Sinai Medical Center, Burns Allen Research Institute, Los Angeles, California.

Address reprint requests to: Jay Schulkin, PhD American College of Obstetricians and Gynecologists Department of Research 409 12th Street, SW Washington, DC 20024-2188 E-mail: jschulkin{at}acog.org

Objective: To characterize the clinical decisions, knowledge, opinions, and education of obstetricians and gynecologists about antenatal corticosteroids.

Methods: Questionnaires mailed to 1020 ACOG Fellows included items on demographics, knowledge, clinical practice patterns, and educational background regarding antenatal corticosteroids.

Results: The survey response rate was 47.8%. Almost all respondents (94%) reported administering antenatal corticosteroids, with reduction of respiratory distress syndrome (82%) as the primary reason for antenatal corticosteroid administration. Most (59.2%) were unaware of newly recognized associations between multiple administrations of corticosteroids and fetal growth restriction. In hypothetical clinical situations, responses by physicians who completed their residency training before 1970 indicated less likelihood to administer corticosteroids when administration is relatively indicated per National Institutes of Health (NIH) and ACOG guidelines than those trained later (P < .001). Only 8% of the entire sample rated their knowledge of antenatal corticosteroids as comprehensive; most (68%) rated it as adequate. Respondents rated residency training as a much better source of antenatal corticosteroid knowledge than medical school.

Conclusion: Most obstetrician-gynecologists reported using antenatal corticosteroids; however, in general, many were not aware of more recent information regarding potential risks. This survey suggests that a multipronged educational approach is warranted to update obstetrician-gynecologists about antenatal corticosteroids.

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