We Should Proceed With Caution When It Comes to Antenatal Corticosteroids After 34 Weeks

Area of Science:

• Obstetrics and Gynecology
• Neonatal Medicine
• Pharmacology

Background:

• The Society for Maternal-Fetal Medicine supports antenatal corticosteroids for high-risk late preterm birth.
• Use of antenatal corticosteroids after 34 weeks' gestation has increased, citing reduced respiratory morbidity.
• Evidence suggests decreasing respiratory morbidity with antenatal corticosteroid use after 34 weeks.

Discussion:

• The absolute benefits of antenatal corticosteroids after 34 weeks are relatively small.
• Potential long-term harms associated with antenatal corticosteroid exposure require careful evaluation.
• Balancing benefits against risks is crucial before broadening indications for antenatal corticosteroid use.

Key Insights:

• Increasing use of antenatal corticosteroids for late preterm birth is noted.
• Evidence supports reduced respiratory morbidity but highlights small absolute benefits.
• Long-term safety concerns warrant consideration for expanded use.

Outlook:

• Further research is needed to fully understand long-term corticosteroid effects.
• Clinical guidelines may need re-evaluation regarding antenatal corticosteroid use after 34 weeks.
• A cautious approach is advised for expanding antenatal corticosteroid indications.