Antenatal corticosteroids

A recent randomized controlled trial showed that antenatal corticosteroids reduce neonatal respiratory complications among women at risk of delivery between 34 weeks 0 days and 36 weeks 6 days (the number needed to treat to prevent one case of severe respiratory morbidity was 25).2 Among women at risk of imminent delivery between 22 weeks 0 days and 24 weeks 0 days who choose perinatal resuscitation, a meta-analysis of cohort studies suggested that antenatal corticosteroids may reduce the risk of neonatal in-hospital mortality by 52%.3 A single course of antenatal corticosteroids between 24 and 34 weeks is associated with a reduced risk of cerebral palsy and severe disability4 without an increase in maternal infections.1 However, neonatal hypoglycemia has been observed when antenatal corticosteroids are administered after 34 weeks.2 Adults exposed to antenatal corticosteroids in utero have higher rates of insulin resistance (but not diabetes).1