No. 364-Antenatal Corticosteroid Therapy for Improving Neonatal Outcomes

Area of Science:

• Obstetrics and Gynecology
• Neonatal Medicine
• Pharmacology

Background:

• Preterm birth poses significant risks for neonatal morbidity and mortality.
• Antenatal corticosteroid therapy is a key intervention to improve neonatal outcomes.

Purpose of the Study:

• To evaluate the benefits and risks of antenatal corticosteroid therapy in women at risk of preterm birth or undergoing pre-labour Cesarean section.
• To provide recommendations for optimizing neonatal and long-term outcomes.

Main Methods:

• Systematic review of randomized controlled trials and cohort studies from Medline, PubMed, Embase, and Cochrane Library (up to September 2017).
• Inclusion of statements from major professional organizations.
• Focus on perinatal and maternal morbidity, mortality, and neurodevelopmental outcomes.

Main Results:

• A course of antenatal corticosteroids within 7 days of delivery significantly reduces perinatal morbidity and mortality for preterm births (24+0 to 34+6 weeks).
• Potential for adverse effects to outweigh benefits when therapy is given >7 days before delivery or after 34+6 weeks.
• Limited evidence exists on long-term effects and potential neurodevelopmental harms from late preterm, term, or repeated exposures.

Conclusions:

• Antenatal corticosteroids are beneficial for preterm birth prevention when administered appropriately.
• Careful consideration of timing and potential risks is crucial, especially for late preterm, term, or repeated exposures.
• Further research is needed to fully understand long-term neurodevelopmental outcomes.