Optimization of Antenatal Corticosteroid Therapy in Preterm Birth
Main Article Content
Abstract
Antenatal corticosteroids (ACS) have been shown to reduce the risk of peripartal and neonatal mortality, as well as respiratory distress syndrome (RDS), and likely intracranial hemorrhage. The administration of ACS represents standard therapy in pregnant women at high risk of imminent preterm birth. The 2015 recommendations of the World Health Organization emphasize that ACS provide proven clinical benefits when administered under appropriate conditions but may also cause significant adverse effects if the indications and criteria are not fully met. The aim of this study was to present the course and outcome of pregnancy and neonatal outcomes in women who received ACS according to protocol. All pregnant women admitted with a diagnosis of threatened preterm birth during a six-month period were analyzed. A total of 141 pregnant women received ACS up to 34 weeks of gestation. The total number of preterm births during the same period according to the protocol of the maternity department was 193, of which 78 (40%) occurred before 34 weeks of gestation.The results showed that 52 (66.6%) women received ACS and delivered preterm, while in 24 (33.3%) women who delivered preterm ACS therapy had not been administered.
Article Details
The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.
References
2. Liggins GC, Howie RN. A controlled trial of antepartum glucocorticoid treatment for prevention of the respiratory distress syndrome in premature infants. Pediatrics. 1972;50(4):515–525.
3. Roberts D, Brown J, Medley N, Dalziel SR. Antenatal corticosteroids for accelerating fetal lung maturation. Cochrane Database Syst Rev. 2017;3: CD004454.
4. World Health Organization. WHO recommendations on interventions to improve preterm birth outcomes. Geneva, Switzerland: World Health Organization; 2015.
5. American College of Obstetricians and Gynecologists. Antenatal corticosteroid therapy for fetal maturation. Committee Opinion No. 713. Obstet Gynecol. 2017;130(2):e102–e109.
6. Garite TJ, Kurtzman J, Maurel K, Clark R. Impact of a “rescue course” of antenatal corticosteroids: a multicenter randomized controlled trial. Am J Obstet Gynecol. 2009;200(3):248.e1–248.e9.
7. Crowther CA, Middleton PF, Voysey M, et al. Effects of repeat prenatal corticosteroids given to women at risk of preterm birth: an updated systematic review and meta-analysis. Cochrane Database Syst Rev. 2015;7:CD003935.
8. Rohwer AC, Oladapo OT, Hofmeyr GJ; Cochrane Pregnancy and Childbirth Group. Strategies for optimising antenatal corticosteroid administration for women with anticipated preterm birth. Cochrane Database Syst Rev. 2020;5:CD013633.
9. Kiran N, Sugee KL, Kellie EM, et al. Evaluation of long-term outcomes associated with preterm exposure to antenatal corticosteroids: a systematic review and meta-analysis. JAMA Pediatr. 2022;176 (6):e220483.
10. Nuran U, Hanim M, Abdülkadir T, Sertaç A, Fahri O. Does antenatal corticosteroid therapy improve neonatal outcomes in late preterm birth? J Matern Fetal Neonatal Med. 2022;35(25):9105–9111.
11. Sarah AN, Han-Yang C, Suneet PC, et al. Gestational diabetes mellitus and late preterm birth: outcomes with and without antenatal corticosteroid exposure. Am J Obstet Gynecol MFM. 2024;6(3): 101268.