Antenatal steroids have been a part of the management of babies at risk of being born prematurely since the 70s, and PERIPrem is not introducing anything new.
What we are aiming to help you achieve is the timely delivery of a complete course of antenatal steroids to all women where it is applicable, through helping you to culture a renewed enthusiasm, provide resources and support your team to implement effective quality improvement.
Your local PERIPrem team may find it more manageable to appoint sub-teams /champions to focus on each bundle element, but however you choose to manifest change in your centre, please have a look the resources we have already created below to help your team to aim higher.
We encourage you to look across the three “capsules” of Process, Training and Education and Communications and Engagement when planning and implementing any changes, we know from experience that action needs to be taken across all three capsules to see a progress. These areas will be covered in the unit-level training.
Pay attention to how you will embed and sustain the improvements you have made and you can use the embedding and sustaining change tool (coming soon) to shape your thinking in doing so.
Resources
We have a package of resources to support implementation of this PERIPrem bundle element. Please watch the video and download the resources to find out more.
Please tell us a bit about yourself to download our PERIPrem resources
- Our November 2023 Learn and Share event focussed on Antenatal Steroids. You can access the slides and audio recording of the event. Health Innovation Oxford & Thames Valley kindly shared their data collection tool and spreadsheet which we adapted for the session. If your unit is not regularly achieving optimisation of antenatal steroids then we hope these tools can help you explore this within your area
Links for more information
If you would like to understand more about the evidence behind this PERIPrem bundle element, the following papers, reviews and websites have more information.
- NNAP (RCPCH) 2020 Audit standards, set by NNAP Project Board.
- BAPM: Perinatal Management of Extreme Preterm Birth Before 27 Weeks of Gestation (2019). Available here
- NICE Guidance for Preterm Birth (2019)
- Royal College of Obstetricians and Gynaecologists e-learning. Antenatal Corticosteroids to Reduce Neonatal Morbidity and Mortality. Green-top Guideline 7. London; RCOG Press: 2010.
- Baud O, Foix-L’Helias L, Kaminski M, Audibert F, Jarreau PH, Papiernik E et al. Antenatal glucocorticoid treatment and cystic periventricular leukomalacia in very premature infants. N Engl J Med 1999;341:1190–6. (link is external)
- Brownfoot FC, Gagliardi DI, Bain E, Middleton P, Crowther CA. Different corticosteroids and regimens for accelerating fetal lung maturation for women at risk of preterm birth. Cochrane Database Syst Rev 2013;(8):CD006764. (link is external)
- Roberts D, Dalziel SR. Antenatal corticosteroids for accelerating fetal lung maturation for women at risk of preterm birth. Cochrane Database Syst Rev 2006;(3):CD004454.
- Crowther CA, Middleton PF, Voysey M, Askie L, Zhang S, et al. (2019) Effects of repeat prenatal corticosteroids given to women at risk of preterm birth: An individual participant data meta-analysis. PLOS Medicine 16(4): e1002771. https://doi.org/10.1371/journal.pmed.1002771
