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Use of antenatal corticosteroids in the management of preterm delivery

Anthony K Msan1, Ihab M Usta1, Fadi G Mirza1

  • 1Department of Obstetrics & Gynecology, American University of Beirut Medical Center, Beirut, Lebanon.

American Journal of Perinatology
|December 24, 2014
PubMed

Insights

Antenatal corticosteroids like betamethasone accelerate fetal lung development and improve survival for premature births. However, optimal use in specific preterm populations and alternative regimens require further investigation.

Area of Science:

  • Obstetrics and Gynecology
  • Neonatology
  • Pharmacology

Background:

  • Preterm birth remains a leading cause of neonatal morbidity and mortality.
  • Antenatal corticosteroids are a cornerstone of management for impending preterm delivery.
  • Evidence supports their role in accelerating fetal lung maturation and improving neonatal outcomes.

Purpose of the Study:

  • To review current evidence and recommendations for antenatal corticosteroid use in preterm deliveries.
  • To explore related issues, concerns, and uncertainties surrounding their application.
  • To synthesize findings on the efficacy and safety of established and alternative regimens.

Main Methods:

  • Narrative literature review.
  • Synthesis of findings from computerized databases and authoritative medical texts.
  • Focus on antenatal corticosteroids and prematurity.

Main Results:

  • Antenatal corticosteroids (betamethasone, dexamethasone) accelerate pulmonary development and mature other fetal organ systems.
  • Administration significantly reduces neonatal morbidities and increases survival rates in preterm infants.
  • Established protocols demonstrate clear benefits for fetal development and neonatal outcomes.

Conclusions:

  • Uncertainties persist regarding the efficacy of current protocols in very early, late preterm, and multiple gestations.
  • Alternative corticosteroid regimens are controversial due to concerns about adverse effects and risk-benefit balance.
  • Further research is needed to refine protocols for specific high-risk preterm populations.
Abstract

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