A conference report on prenatal corticosteroid use in low- and middle-income countries

Area of Science:

• Obstetrics and Gynecology
• Neonatal Care
• Global Health

Background:

• Prenatal corticosteroid administration is a key intervention to improve neonatal outcomes.
• Evidence for its effectiveness is primarily from high-income countries with advanced neonatal care.

Purpose of the Study:

• To evaluate existing evidence on prenatal corticosteroid use in low- and middle-income countries (LMICs).
• To provide recommendations for implementation and future research in LMICs.

Main Methods:

• A review of studies and meta-analyses on prenatal corticosteroids relevant to LMICs.
• Information gathered at the Maternal and Child Health Integrated Project (MCHIP) Antenatal Corticosteroid Conference in 2010.

Main Results:

• Strong evidence supports prenatal corticosteroid effectiveness in high- and middle-income countries, typically with high-level newborn care.
• No studies have evaluated prenatal corticosteroid use for births in low-income countries without high-level neonatal care or for out-of-hospital births.
• Efficacy and safety in these specific settings require evaluation.

Conclusions:

• Recommended expanding prenatal corticosteroid use in LMICs within hospitals offering high-level newborn care.
• Further research on efficacy and safety is crucial before widespread introduction in other LMIC settings.