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The ability of a drug to produce structural deformations and functional abnormalities in the developing embryo or the fetus is called teratogenicity, and the drug producing this effect is known as a teratogen. Teratogenic effects include stillbirth, miscarriage, intrauterine growth restriction, and neurocognitive delay. A teratogen may affect the embryo at different stages of development, which is important in determining the type and extent of the damage. During blastocyst formation, the early...
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Respiratory symptoms, such as congestion and cough, commonly accompany respiratory tract conditions. Various medications, such as antitussives, expectorants, and mucolytics, play crucial roles in providing relief.
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Tuberculosis, often called TB, is a contagious illness primarily caused by Mycobacterium tuberculosis. It mainly affects the lung parenchyma but can also impact other body parts.
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Addressing the long-term risks of administering antenatal steroids.

Sean W D Carter1,2, Agnihotri Biswas3, Hannah R S Watson2,4

  • 1Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.

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|March 4, 2025
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Summary

Antenatal steroid (ANS) therapy reduces preterm birth complications but may pose long-term risks. Careful dosing and patient selection are crucial, especially in later gestations where benefits are less clear.

Keywords:
Antenatal steroidsadverse effectsdevelopmentfetalgrowth restrictionneurodevelopmentpreterm birthprogramming

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Area of Science:

  • Perinatology
  • Neonatology
  • Developmental Toxicology

Background:

  • Antenatal steroid (ANS) therapy is a standard intervention for women at risk of preterm birth.
  • ANS therapy significantly reduces neonatal respiratory distress syndrome, morbidity, and mortality.
  • Potential long-term adverse effects of ANS therapy remain an area of concern.

Purpose of the Study:

  • To review glucocorticoid signaling, pharmacokinetics, pharmacodynamics, and clinical use of ANS.
  • To assess the potential long-term harms associated with ANS therapy.
  • To provide an expert opinion on the risk-benefit balance of ANS therapy.

Main Methods:

  • Review of key concepts in glucocorticoid signaling and pharmacokinetics/pharmacodynamics.
  • Analysis of clinical data regarding the long-term effects of ANS therapy.
  • Expert assessment of current ANS therapy guidelines and practices.

Main Results:

  • High-dose ANS regimens can induce fetal multi-system changes affecting growth and development.
  • Long-term risks appear to correlate with the dose and duration of steroid exposure.
  • Single-course ANS therapy between 24-34 weeks gestation is generally justified.

Conclusions:

  • Optimizing ANS dosing and patient selection is essential.
  • At periviable gestations, immediate survival benefits outweigh modest long-term risks.
  • Routine ANS use in late preterm and term gestations requires further evaluation due to limited benefits.