Title:Efficacy and Safety of Corticosteroids’ Administration for Pulmonary Immaturity in Anticipated Preterm Delivery
Volume: 27
Issue: 36
Author(s): Themistoklis Dagklis, Ioannis Tsakiridis, Georgios Papazisis and Apostolos Athanasiadis*
Affiliation:
- Third Department of Obstetrics and Gynaecology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki,Greece
Keywords:
Corticosteroids, pregnancy, fetal lung maturation, preterm delivery, prematurity, timing, course, outcome.
Abstract: Preterm delivery represents the major cause of neonatal morbidity and mortality. Respiratory morbidity
is the primary cause of early neonatal mortality and disability. The administration of antenatal corticosteroids,
in cases of imminent preterm delivery, can enhance fetal lung maturation and reduce the incidence of
respiratory distress syndrome, leading to improved neonatal outcomes. The scope of this narrative review was
to synthesize available evidence on the efficacy and safety of corticosteroids' administration during antenatal
period, in cases of anticipated preterm delivery. Hence, for those cases, a single course of antenatal corticosteroids
from 24 up to 34 gestational weeks should be offered. Betamethasone and dexamethasone are the most
widely used drugs, with similar effectiveness and a recommended dosage of 24mg in divided doses, over a 24-
hour period. However, there is an ongoing debate regarding the gestational age of administration. Some obstetric
societies recommend their administration even at 22 weeks of gestation. Conflicting is also their usefulness
in late preterm cases (between 34 and 37 weeks) or in cases of elective cesarean delivery at term. The use of
repeated courses of corticosteroids may be considered in specific cases, however, concerns on the long-term
outcomes of repeated courses beyond 34 gestational weeks have been raised.
