We have previously reported that less than 20% of eligible VLBW infants receive antenatal steroid (ANS) treatment. The purpose of this analysis was to compare the rates of ANS therapy and characteristics of women treated with ANS in the Network before and after the Consensus Development Conference (CDC), 2/28/94. ANS treatment of mothers of VLBW infants in the 34 mos before (n = 7610) and the 16 mos after the CDC (n = 3151) were compared. Overall, ANS use increased from 20.6% (center range 1-39%) to 45.9% (27-66%); during the latest available 4-mo period, 55% of VLBW mothers were treated. During both periods patients with prenatal care, multiple gestation, hypertension/preeclampsia, diabetes, c-section, tocolytics or antibiotics were more likely (OR 1.09- 4.58) and those with antepartum hemorrhage or labor were less likely (OR 0.62- 0.76) to receive ANS. Patients with PROM and prolonged ROM were less likely before the CDC (OR 0.74 and 0.76, respectively) and more likely after the CDC(OR 1.66 and 1.87, respectively) to receive ANS. The OR for ANS plus antibiotics increased from 1.86 to 3.78 post CDC. ANS increased approximately 2-fold in all GA groups after the CDC: Table

Table 1
Full size table

The mutivariable adjusted OR for ANS indicated that mothers of VLBW infants were 3.1 times more likely to receive ANS after the CDC than before, after adjusting for potential selection factors (listed above). We conclude that ANS usage is a good example of the effectiveness of a NIH CDC in altering physicians' management behavior.