Abstract
The administration of a single course of corticosteroids before week 34 + 0 of gestation
in cases with impending preterm birth is now standard procedure in obstetric care
and firmly
established in the guidelines of different countries. But despite the apparently
convincing data, numerous aspects of this intervention have not yet been properly
studied. It is still not
clear which corticosteroid achieves the best results. There are very few studies
on what constitutes an appropriate dose, circadian rhythms, the time frame in which
corticosteroids are
effective, and the balance between the risks and benefits of repeat administration.
As the existing studies have rarely included patients before week 24 + 0 of gestation,
we have very little
information on the possible benefits of administering corticosteroids before
this timepoint. If corticosteroids are administered antenatally after week 34 + 0
of gestation, the short-term
benefit may be offset by the long-term adverse effect on psychomotor development.
This present study summarizes the current state of knowledge regarding these issues.
Key words
corticosteroids - preterm birth - dose - timing
