Antenatal corticosteroid therapy: Historical and scientific basis to improve preterm birth management

Carlos Briceño-Pérez1, Eduardo Reyna-Villasmil2, Paulino Vigil-De-Gracia3

  • 1Department of Obstetrics and Gynecology, University of Zulia, Maracaibo, Venezuela.

Insights

Antenatal corticosteroids (ACS) therapy significantly reduces complications and mortality in premature infants. This evidence-based practice is recommended for women delivering before 34 weeks gestation.

Area of Science:

  • Obstetrics and Gynecology
  • Neonatology
  • Pharmacology

Background:

  • Antenatal corticosteroids (ACS) therapy has a well-established historical and scientific foundation.
  • Initiated in 1972, its efficacy has been consistently supported by meta-analyses and consensus conferences.

Purpose of the Study:

  • To review the historical and scientific basis of antenatal corticosteroids (ACS) therapy.
  • To highlight its role in improving the management of preterm birth and reducing infant complications.

Main Methods:

  • Literature search of MEDLINE/PubMed and Cochrane Library.
  • Utilized keywords such as "ACS", "corticosteroids", "betamethasone", "dexamethasone", and "preterm birth".

Main Results:

  • ACS therapy is a crucial evidence-based practice for reducing mortality and complications in premature infants.
  • Established benefits include decreased rates of respiratory distress syndrome, intraventricular hemorrhage, and necrotizing enterocolitis.

Conclusions:

  • ACS treatment is unequivocally recommended for women delivering before 34 weeks gestation.
  • Rescue courses are advised, but multiple, serial, or weekly courses are not.
  • ACS is recommended in specific conditions like preterm premature rupture of membranes, multiple pregnancies, severe preeclampsia/HELLP syndrome, and fetal growth restriction.
Abstract

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