Time for ACTion:

Comprehensive Recommendations for Antenatal Corticosteroid Treatment (ACT) for the Next Decade

June 2-3, 2014

Dulles Marriott

Conference Recordings Now Available

Lead Funding Agency:
Agency for Healthcare Research and Quality

Small Grant Program for Conference Support
PA09-231 / R13 HS21037-01A1

Conference Co-Sponsors:
Day Before Birth
March of Dimes

Platinum Sponsor:
American Congress of Obstetricians and Gynecologists


Educational Grantor:
Hologic, Inc.

Conference Organizer:
Day Before Birth

We were most delighted with the collaborative spirit displayed both in the meeting and the hallways at our conference "Time for ACTion: Comprehensive Recommendations for Antenatal Corticosteroid Treatment (ACT) for the Next Decade" (June 2-3 at the Dulles Marriott.)

With 70 attendees--physicians, nurses, research scientists, quality improvement advocates and public health leaders--the conference was likely the largest and most diverse gathering of maternal child health experts to advocate for antenatal corticosteroid treatment in at least a decade.

We are grateful to all the participants and sponsors, particularly to our leading funding agency the Agency for Healthcare Research and Quality, our co-sponsor the March of Dimes, our platinum sponsor the American Congress of Obstetricians and Gynecologists and our educational grantor Hologic.

The conference has already had an early impact on national initiatives to improve appropriate antenatal corticosteroid treatment.

In the conference evaluation, over 90 percent of attendee respondents said they agreed with the following statement: "Having attended the conference, I feel I am better prepared and motivated to lead or advocate for a quality improvement program or other type of program to improve appropriate antenatal corticosteroid treatment in the US or around the world."

One attendee wrote anonymously on our evaluation form: "This was a phenomenal meeting, one of the best I have attended in the past five years. Thank you!"

The goal of the conference was to improve the health and life course of premature infants by stimulating new research, practice and policy to increase appropriate utilization of antenatal corticosteroid treatment (ACT) and by developing comprehensive recommendations for the next decade.

In the US, preterm birth is the leading cause of newborn death; it is a major determinant of all infant mortality/morbidity; and it is responsible for complications that impact the health of children and their families throughout their lives. Rates of preterm birth (12.0% in 2010) continue to be well above the Healthy People 2020 objective of 11.4% —a rate that may be achievable but is still too high. For decades, the NIH, the Joint Commission, ACOG and many other leading institutions have recommended ACT treatment—offered ideally 48 hours before delivery--as one of the most effective treatments to improve the survival and health of infants born prematurely between 24 and 34 weeks gestation. Top institutions generally comply with treatment guidelines, but treatment rates are very uneven, below 25% in many communities. Out of the 170,000 women who deliver early (24-34 weeks) annually in the US, more than half deliver within 48 hours of hospital admission and therefore fail to get optimal treatment. Existing quality improvement practices, if applied, could make a difference—the prime motivation of this conference. If all eligible for ACT were fully treated, it is estimated that more than 1,000 newborn lives might be saved, a 5% reduction in neonatal mortality rates.

On June 2-3 of 2014 at the Marriott Dulles near Washington, DC, the conference convened a multidisciplinary group of 70 leading experts from academia, government and the private sector; and in particular, the event endeavored to broaden the ACT movement within the public health community and to involve women more consciously and programmatically, utilizing patient-centered care models. The conference fostered recent advances in translational research to help assure evidence-based guidelines and successful ACT quality improvement programs are implemented locally and nationally.