How well are international guidelines followed for certain medications for high-risk pregnancies?

Prenatal magnesium sulfate and steroids can reduce the risks of cerebral palsy and respiratory complications in preterm infants. A review in the International Journal of Gynecology & Obstetrics found that despite being recommended internationally for pregnant women at risk of preterm delivery, these medications are used variably between and within countries.

When they analyzed 2012–2024 information on 45,619 babies born at 24–32 weeks’ gestation at 1,111 hospitals in an international network, along with information from the UK National Neonatal Research Database and a literature review, investigators found that on average, less than half of infants had been exposed to preterm magnesium sulfate in middle-income countries, and approximately three-quarters in high-income countries. Even within high-income countries, there were large discrepancies in care. Preterm steroids were used more frequently with less variation, although treatment gaps were still apparent.

“Our study has highlighted the international disparities in how two key treatments to protect pre-term babies are implemented. These gaps aren’t because of a lack of evidence,” said corresponding author Hannah B. Edwards, MA, MSc, of the University of Bristol, in the UK. “Lessons can be learned from successful implementation programs like PReCePT, which has transformed use of magnesium sulphate in pre-term births in England. The bigger-picture goal should now be to ensure that no matter where a baby is born, their mother has access to the evidence-based treatments that offer the best start in life.”

URL upon publication: https://onlinelibrary.wiley.com/doi/10.1002/ijgo.70832