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Updated: Jun 10, 2026
19:15
Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
[Antenatal corticosteroids: neonatal effects of a second course]
1AP-HP, Hôpital Robert Debré, Service de Gynécologie Obstétrique, Paris, France. thomas.schmitz@rdb.aphp.fr
Summary
Rescue courses of antenatal corticosteroids may improve neonatal pulmonary outcomes without impacting fetal growth. Further research is needed before widespread clinical adoption for preterm birth.
Area of Science:
- Obstetrics and Gynecology
- Neonatal Medicine
- Pharmacology
Context:
- Systematic, repetitive antenatal corticosteroid courses were used in the late 1990s to reduce preterm birth morbidities.
- Randomized trials revealed short-term pulmonary benefits but also concerns regarding fetal growth and neurodevelopmental outcomes with multiple courses.
- These findings led to the discontinuation of routine repetitive courses and the development of the 'rescue course' strategy.
Purpose:
- To evaluate the efficacy and safety of antenatal corticosteroid rescue courses in managing preterm birth complications.
- To determine if rescue courses offer benefits comparable to or exceeding those of multiple courses without the associated risks.
Summary:
- Antenatal corticosteroid rescue courses, administered when delivery is imminent, show potential in reducing acute pulmonary morbidity in neonates.
- Current evidence from two randomized trials suggests no significant adverse effects on fetal growth with rescue courses.
- While promising for early neonatal outcomes, the long-term safety and efficacy require further validation.
Impact:
- Provides evidence supporting a refined approach to antenatal corticosteroid administration in high-risk pregnancies.
- Highlights the need for continued research, including randomized trials and follow-up studies, to establish definitive clinical guidelines.
- Informs clinical practice by suggesting a potential alternative to previous repetitive dosing strategies for antenatal corticosteroids.
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