Grant: Project Grant

Antenatal corticosteroids are a medication given to women who are at risk of an early delivery to help reduce the chance of breathing problems for their baby after birth. Current guidelines recommend giving antenatal corticosteroids to pregnant women who might have their baby before 34 weeks of pregnancy. This medication may also help those at risk of an early delivery at 34 to 36 weeks of pregnancy but the balance between the benefits and harms of this treatment is less clear at these ages. Clinical guidelines for giving this medication at 34 to 36 weeks of pregnancy are also unclear, making it difficult for doctors and patients to decide whether to use it. We previously found that many doctors are not talking about this decision with patients, or when they do talk about it, different doctors discuss different risks and benefits. Decision support tools that clearly state risks and benefits can sometimes help doctors and patients make decisions about whether a treatment is right for them. Our goal is to find out if including a decision support tool in clinical guidelines will improve how doctors discuss antenatal corticosteroids with patients who might deliver at 34 to 36 weeks of pregnancy. We will ask patients who delivered at these preterm ages whether their doctor discussed antenatal corticosteroids with them, and see if they report having had better discussions with their doctor about this treatment decision after their doctor had access to the decision support tool within the clinical guideline. We will also ask doctors if and how this decision support tool impacts their counselling. By helping doctors and patients communicate about the risks and benefits of antenatal corticosteroids, this project could promote fully-informed and optimal use of a drug that can reduce breathing problems in newborns. Our results could also serve as a model for other clinical guidelines when there is no clear answer about whether the benefits of a treatment outweigh its harms.