Antenatal Corticosteroids: Extending the Practice for Late-Preterm and Scheduled Early-Term Deliveries?

Area of Science:

• Neonatal Medicine
• Obstetrics
• Pediatric Pulmonology

Background:

• Respiratory distress is common in late-preterm and early-term infants, often requiring special care.
• Respiratory distress syndrome and transient tachypnea of the newborn are leading causes of neonatal respiratory morbidity.
• Antenatal corticosteroids (ACS) are known to improve lung maturity by enhancing surfactant production and fluid resorption.

Purpose of the Study:

• To review the short-term benefits of antenatal corticosteroids (ACS) in reducing respiratory morbidities in late-preterm and early-term infants.
• To discuss potential long-term adverse effects associated with ACS administration.
• To provide an update on current practices and considerations for ACS use in pregnancies beyond 34 weeks gestation.

Main Methods:

• Literature review of studies on antenatal corticosteroid use in late-preterm and early-term infants.
• Analysis of data regarding respiratory outcomes and potential adverse effects.
• Examination of current clinical guidelines and expert opinions on ACS administration.

Main Results:

• ACS has demonstrated benefits in preterm infants (<34 weeks gestation) for reducing respiratory distress.
• Evidence suggests potential benefits of ACS may extend to infants born between 34 and 37 weeks gestation.
• The review addresses both the advantages and potential disadvantages of ACS in this population.

Conclusions:

• Antenatal corticosteroids show promise in mitigating respiratory morbidities in late-preterm and early-term infants.
• Further research is needed to fully understand the long-term implications and optimal use of ACS in pregnancies >34 weeks.
• Clinical practice guidelines may need updates to reflect the evolving evidence on ACS benefits and risks.