Evidence from this updated 2020 Cochrane review supports the continued use of a single course of antenatal corticosteroids to accelerate fetal lung maturation in women at risk of preterm birth. Treatment with antenatal corticosteroids reduces the risk of perinatal death, neonatal death and RDS and probably reduces the risk of IVH.
This review (of 27 randomized trials including 11,272 women and 11,925 neonates) assessed the effect of administering a course of corticosteroids to women prior to anticipated preterm birth (before 37 weeks) on fetal and neonatal morbidity and mortality, maternal morbidity and mortality, and childhood development later in life. Evidence supports the continued use of a single course of ACS to accelerate fetal lung maturation in women at risk of preterm birth to reduce the risk of serious respiratory illness and death in neonates in low- and middle-income countries.
Neonatal outcomes from this analysis found:
- Reduced risk of perinatal death (numbers of stillbirths and babies dying in the first 28 days of life)
- Reduced risk of early neonatal death (numbers of babies dying in the first 28 days of life)
- Reduced risk of severe respiratory distress at 24 hours after birth
- Minor effect on babies’ birth weight