Prenatal corticosteroids: what's new?

Preterm delivery is an important cause of morbidity and mortality. The administration of a single course of corticosteroids antepartum in women at risk of preterm delivery (24+0 - 34+6 weeks of gestation) is associated with a significant reduction of these complications without increasing the short and long term maternal and neonatal risks. There is less certainty about the administration of repeated cycles where the woman remains at high risk of preterm delivery 7 days after the initial treatment. Repeated cycles seem to be beneficial in the short term, but there is no agreement and sufficient information on what might be the long-term effects on the infant exposed to multiple cycles during intrauterine life. Therefore, the administration of repeated cycles should be reserved to women involved in randomized controlled trials. Finally, further studies should be conducted to clarify many questions still with no definitive answer: duration of effect of corticosteroids, necessity of repeated cycles, risks of repeated administration, ideal medication and dosage, long-term effects, the role of corticosteroids in particular situations (elective caesarean section, intrauterine growth restriction, diabetes in pregnancy).