In 2016, a multicenter trial by the NICHD MFMU Network evaluating the benefit of antenatal betamethasone therapy in patients at risk for delivering in the late preterm period (34 0/7 – 36 6/7 weeks) was published. This study suggested a modest, yet statistically significant benefit in composite respiratory outcome from betamethasone therapy when compared to placebo (11.6% vs. 14.4%).
Since the publication of this study, providers at Northwest Perinatal Center (NWP) have been cautious to advocate widespread use of antenatal late preterm steroids (ALPS) until a standardized approach to appropriately identifying and counseling patients was created. During this time, our maternal-fetal medicine physicians and neonatologists at Northwest Newborn Specialists (NWNS) have collaborated to develop guidelines and supporting resources. Additional work with the Providence System workgroup has provided EMR decision support within the Providence inpatient Epic EMR.
The NWP Antenatal Late Preterm Steroids (ALPS) Protocol was designed to serve as a resource for our referring providers to:
- Assist in identifying eligible patients and minimizing the use of ALPS in patients with exclusions; and
- Provide speaking points for patient counseling when obtaining informed consent for ALPS therapy, which we recommend for all patients for whom ALPS therapy is being considered.
Laminated copies will also be distributed to local hospitals to have available on labor and delivery. If you have questions, please feel free to contact one of the MFMs at Northwest Perinatal Center.