Tip 17b: antenatal steroids

Treatment with antenatal corticosteroids in preterm babies is associated with an overall reduction in:

  • perinatal death (RR 0.72, 95% CI 0.58 to 0.89)
  • neonatal death (RR 0.69, 95% CI 0.59 to 0.81)
  • RDS (RR 0.66, 95% CI 0.56 to 0.77)
  • intraventricular haemorrhage (RR 0.55, 95% CI 0.40 – 0.76)
  • NEC (RR 0.50, 95% CI 0.32 – 0.78)
  • systemic infections in the first 48 hours of life (RR 0.60, 95% CI 0.41 – 0.88).

There was no obvious difference in chronic lung disease, death in childhood or neurodevelopment delay.

The studies included in this Cochrane review cover a wide range of gestational ages from 24+0 to 36+6. Some sub-group analysis shows a greater benefit for <35+0, and limited or no effect for >34+0.

References:

Roberts D, Brown J, Medley N, Dalziel SR. Antenatal corticosteroids for accelerating fetal lung maturation for women at risk of preterm birth. Cochrane Database of Systematic Reviews 2017, Issue 3. Art. No.: CD004454.

National Institute for Health and Care Excellence (2015). Preterm labour and birth. NICE guideline NG25. London: NICE.

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