What is Antenatal Corticosteroids?

Antenatal steroids, also known as Antenatal Corticosteroids, are medications administered to pregnant women expecting a preterm birth. When administered, these steroids accelerate the maturation of the fetus’ lungs, which reduces the likelihood of infant respiratory distress syndrome and infant mortality. The effectiveness of this corticosteroid treatment on humans was first demonstrated in 1972 by Sir Graham Liggins and Ross Howie, during a randomized control trial using betamethasone.

Antenatal Corticosteroid Therapy for Fetal Maturation

The American College of Obstetricians and Gynecologists (ACOG) Committee on Obstetric Practice has issued recommendations for the administration of antenatal corticosteroid therapy for fetal maturation. According to the committee opinion, corticosteroid administration before anticipated preterm birth is one of the most important antenatal therapies available to improve newborn outcomes.

Administration of corticosteroids for pregnant women during the periviable period who are at risk of preterm delivery within 7 days is linked to a family’s decision regarding resuscitation and should be considered in that context.

A single course of betamethasone is recommended for pregnant women between 34 0/7 weeks and 36 6/7 weeks of gestation at risk of preterm birth within 7 days, and who have not received a previous course of antenatal corticosteroids.

Regularly scheduled repeat courses or serial courses (more than 2) are not currently recommended.

A single repeat course of antenatal corticosteroids should be considered in women who are less than 34 0/7 weeks of gestation who have an imminent risk of preterm delivery within the next 7 days, and whose prior course of antenatal corticosteroids was administered more than 14 days previously. Rescue course corticosteroids could be provided as early as 7 days from the prior dose, if indicated by the clinical scenario.

Continued surveillance of long-term outcomes after in utero corticosteroid exposure should be supported. Quality improvement strategies to optimize appropriate and timely antenatal corticosteroid administration are effective and should be encouraged.