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Current evidence for prenatal and postnatal corticosteroids in preterm infants
Eric S Shinwell1,2, Polina Gurevitz3, Igor Portnov3
1Neonatology, Ziv Medical Center, Tzfat, Israel eric.s@ziv.health.gov.il.
Summary
Antenatal corticosteroids improve infant outcomes, but updated dosing may be beneficial. Research explores alternatives to systemic dexamethasone for preventing bronchopulmonary dysplasia.
Area of Science:
- Neonatal medicine
- Pharmacology
- Pulmonology
Background:
- Antenatal corticosteroids are crucial for neonatal survival and health.
- Current dosing schedules have remained unchanged since 1972.
- Emerging evidence suggests lower doses may suffice, with most long-term studies showing no adverse effects.
Purpose of the Study:
- To review the current evidence on antenatal corticosteroid use, including in COVID-19.
- To explore alternative postnatal corticosteroid therapies for preventing bronchopulmonary dysplasia.
- To highlight promising areas for future research in corticosteroid treatment.
Main Methods:
- Review of recent studies on antenatal corticosteroid efficacy and safety.
- Analysis of long-term outcome data.
- Evaluation of alternative postnatal corticosteroid strategies.
Main Results:
- Antenatal corticosteroids significantly improve neonatal outcomes.
- Lower doses of antenatal corticosteroids may offer similar benefits.
- Alternatives like systemic hydrocortisone and inhaled corticosteroids show promise for preventing bronchopulmonary dysplasia without adverse effects.
Conclusions:
- Current antenatal corticosteroid guidelines should be critically reviewed for potential optimization.
- Alternative postnatal corticosteroid therapies warrant further investigation.
- The combination of surfactant and corticosteroids is a key area for future research.
