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September 27, 1995

Corticosteroids for Fetal Maturation

Author Affiliations

Central Texas Perinatal Associates Austin

JAMA. 1995;274(12):943. doi:10.1001/jama.1995.03530120035030

To the Editor.  —I read with interest the National Institutes of Health (NIH) Consensus Conference article on the effect of corticosteroids for fetal maturation on perinatal outcomes.1 While I realize that it is not my charge as a practicing maternal-fetal medicine specialist to debate the NIH on the details of steroid administration in pregnancy, I do respectfully request clarification. Specifically, in the last bulleted paragraph in section 6 (What are the recommendations for the use of antenatal steroids?) on page 417 ("In complicated pregnancies where delivery prior to 34 weeks' gestation is likely, antenatal corticosteroid use is recommended..."), what exactly does the word "likely" mean? While nearly everyone would agree that a patient with painful contractions, a changing cervix, and intact membranes at 30 weeks is a candidate for glucocorticoid administration, what about a patient with painful contractions, intact membranes, and no cervical change at 30 weeks? Such patients are

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