Antenatal steroids have been shown to reduce the morbidity and mortality of hyaline membrane disease. They have also been shown to have definite beneficial effect even in conditions of preterm premature rupture of membranes. Current evidence suggests that giving antenatal corticosteroids reduces late miscarriages and baby deaths. The baby is also less likely to have respiratory distress syndrome, or need assistance breathing. They are also less likely to have intraventricular hemorrhage, NEC, or systemic infections in the first two days of their life. Steroids do not appear to increase the number of women who develop infection of the fetal membranes or of the womb. This research evidence is mostly from mid- to high-income countries. However, there is not a lot of research into giving antenatal corticosteroids to women in low-income countries where infections are more common. More research is needed to find out the effects of these steroids on women and babies in low-income countries. A study in 2020 suggests exposure to maternal antenatal corticosteroidtreatment is significantly associated with mental and behavioral disorders in children.
Drugs
and betamethasone are the corticosteroids used for the purpose although the former is recommended over the latter based on its efficacy, safety, wide availability, and low cost in spite of some counter-logic. Betamethasone, on the other hand, is preferred over dexamethasone because it is thought to have better prophylaxis of brain softening of premature fetus. They are used with the intention to help the lungs of a premature fetus develop before the fetus comes out. They are given when the fetus is expected to be delivered within 24 to 48 hours. Treatment consists of 2 doses of 12 mg of betamethasone given intramuscularly 24 hoursapart or 4 doses of 6 mg of dexamethasone given intramuscularly 12 hours apart. Optimal benefit begins 24 hours after initiation of therapy and lasts 7 days. Antenatal steroids are currently used up to 36 weeks in some parts of the worldobstetric practice. The time between administration of steroids and delivery may alter the effectiveness of the steroids.
