From 06.11.2025 the NNAP started reporting course durations for “Adherent” patients in the Antenatal Steroids measure. These are currently available only in the Details column of the Patient List in the Restricted Access Dashboard (RAD).

The current classifications are:

• Short (course duration is less than 18 hours)
• Long (course duration is greater than 18 hours)
• Unknown (one or more doses are missing or illogical).

In the January 2026 update of the RAD, these will be updated to:

• Appropriate

• • Betamethasone: course duration is between 18 and 30 hours, in line with the recommended two doses 24 hours apart.
  • Dexamethasone: course duration is between 18 and 42 hours, in line with either the recommended two doses 24 hours apart, or 4 doses 12 hours apart.

• Unknown (dose interval cannot be calculated, or is illogical)
• Inappropriate (dose interval can be calculated but is not “Appropriate”).

If the steroid name is missing it will be imputed as Betamethasone.

These classifications are based on the RCOG Green-top Guidline no. 74, allowing a buffer of 6 hours around the recommended dosing intervals.

A longitudinal line will also be added to the Antenatal Steroids measure of the RAD in the coming months. This will display the proportion of patients who are “Adherent” in the headline measure and have an “Appropriate” dose duration. The denominator for this proportion will be the same as for the headline measure.

It is expected that these new sub classifications will also be presented in the 2025 Extended Analysis report. For the time being, these additions will not affect the headline measure classifications of Adherent, Missing and Not adherent.

If you have any questions about this change, please don’t hesitate to contact us via nnap@rcpch.ac.uk