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Antenatal Corticosteroids at 34 Weeks Gestation

BMJ; 2016 Oct 12; Saccone, Berghella, et al

Women given antenatal steroids at ≥34 weeks’ gestation saw a reduction in neonatal respiratory morbidity, a recent study found. A meta-analysis of 6 trials, including 5,698 singleton pregnancies, were analyzed. 3 trials included 3,200 women at 34 to 36 weeks’ gestation and at risk of imminent premature delivery at the time of hospital admission. The other 3 trials included 2,498 women undergoing planned cesarean delivery at ≥37 weeks. Researchers found:

  • Overall, infants of mothers who received antenatal corticosteroids at ≥34 weeks had a significantly lower risk of respiratory distress syndrome (RDS), mild RDS, moderate RDS, transient tachypnea of the newborn, severe RDS, use of surfactant, and mechanical ventilation, and a significantly lower time receiving oxygen and shorter stay on a neonatal intensive care unit, compared with controls.
  • Infants of mothers who received antenatal betamethasone at 34 to 36 weeks’ gestation had a significantly lower incident of transient tachypnea of the newborn, severe RDS, and use of surfactant.
  • Infants of mothers undergoing planned cesarean delivery at ≥37 weeks’ gestation who received prophylactic antenatal corticosteroids 48 hours before delivery had a significantly lower risk of RDS, mild RDS, moderate RDS, transient tachypnea of the newborn, mechanical ventilation, and significantly less time receiving oxygen, as well as a shorter stay in neonatal intensive care.

Citation:

Saccone G, Berghella V. Antenatal corticosteroids for maturity of term or near term fetuses: Systematic review and meta-analysis of randomized controlled trials. [Published online ahead of print October 12, 2016]. BMJ. doi:10.1136/bmj.i5044.