Background: Antenatal corticosteroids have proven to be beneficial to the newborn but no effectiveness has been seen in mothers. Death due to preterm birth is not uncommon, but antenatal steroids are not routinely used in developing countries. We assessed the effectiveness of antenatal corticosteroids in late preterm period.

Methods: This is a retrospective analysis of prospectively collected data of mothers with singleton pregnancies at risk of prematurity. A course of antenatal corticosteroid therapy (dexamethasone, minimum one dose) was administered within 7 days of delivery; perinatal morbidity and mortality was studied and compared to those who did not receive corticosteroids (control).

Results: A total of eighty patients (forty in each group) were included. Baseline characteristics in the two groups were comparable. There was a lower incidence of requirement of invasive ventilation (30% vs. 85%, p < 0.001), development of neonatal necrotizing enterocolitis (0% vs. 12.5%, p = 0.021), need for surfactant (25% vs. 80%, p < 0.001), neonatal mortality (0% vs. 27.5%, p < 0.001) and higher incidence of discharge to home (100% vs. 72.5%, p < 0.001) in those that received steroids compared to the control group. Perinatal morbidity, including respiratory distress syndrome, intraventricular hemorrhage and bronchopulmonary dysplasia between the two groups was not significant.

Conclusions: Timely administration of antenatal corticosteroids appears safe and significantly reduces perinatal morbidity/mortality in preterm birth. The benefits may outweigh risks but long-term outcomes remain to be studied.

Keywords: Preterm birth, low birth weight, antenatal steroids, respiratory distress syndrome, neonatal mortality.

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Dr Shruti Dhale

Associate Professor and Head of Unit, Department of Pediatrics, Grant Government Medical College and Sir J.J. Group of Hospital Mumbai, Maharashtra, India – 400001