BACKGROUND: Around 1 in 12 babies are born prematurely. Women at risk of preterm birth receive antenatal corticosteroids as part of standard care to accelerate fetal lung maturation and thus improve neonatal outcomes. Steroids affect both maternal and fetal organs and can disturb both glucose control plus have long-term impacts on offspring health.
AIMS: This talk will consider current clinical practice of antenatal corticosteroid use, some of limitations of the evidence and consider potential harms
RESULTS: The dose and formulation of antenatal corticosteroid treatment has not changed significantly since the first clinical trial in 1972. Although clearly beneficial for infant survival in very to moderately preterm infants, there remain key controversies including the use of repeat steroids if delivery does not occur and steroid use at term for planned Caesarean section including in women who have diabetes.
CONCLUSION: Further research in this area is still needed especially regarding type of corticosteroid and optimal timing . In the meantime care must be taken to maximise benefit but minimise any long term harm.