[Glucocorticoid treatment in pregnancy; is caution the mother of wisdom?]

Area of Science:

• Obstetrics and Gynecology
• Neonatal Medicine
• Perinatal Health

Background:

• Prenatal corticosteroids are crucial for preterm newborns' outcomes.
• Current identification of imminent preterm birth may be suboptimal, leading to unnecessary maternal corticosteroid use.
• Adverse neurodevelopmental effects in offspring are linked to non-indicated corticosteroid exposure.

Purpose of the Study:

• To optimize the identification of imminent preterm birth for timely corticosteroid administration.
• To reduce unnecessary maternal corticosteroid use and associated risks to offspring.
• To explore strategies for improving the selection and timing of antenatal corticosteroid therapy.

Main Methods:

• Review of current practices in antenatal corticosteroid administration.
• Analysis of risks associated with unnecessary maternal corticosteroid use.
• Discussion of potential improvements in predictive methods for preterm birth.

Main Results:

• Timely administration of antenatal corticosteroids significantly improves preterm infant outcomes.
• Inadequate estimation of imminent birth leads to non-indicated corticosteroid use, potentially causing long-term neurodevelopmental issues.
• Improved timing, selection, and potential restraint of re-use can reduce futile corticosteroid administration.

Conclusions:

• Accurate prediction of preterm birth within 48 hours is essential for appropriate corticosteroid use.
• Development of better non-invasive predictors is needed to refine patient selection.
• Further prospective studies are required to enhance antenatal corticosteroid administration protocols.