Antenatal corticosteroids for accelerating fetal lung maturation for women at risk of preterm birth

Abstract

This review is published as a Cochrane Review in the Cochrane Database of Systematic Reviews 2017, 3. Cochrane Reviews are regularly updated as new evidence emerges and in response to comments and criticisms, and the Cochrane Database of Systematic Reviews should be consulted for the most recent version of the Review.

Association of Antenatal Corticosteroids with Neonatal Outcomes among Very Preterm Infants Born to Mothers with Clinical Chorioamnionitis: A Multicenter Cohort Study

“…Reduction of intrauterine inflammation can decrease dysregulation of growth factors, mesenchymal structural proteins, and signaling pathways, which may slow structural changes in the fetal lung, leading to a reduced risk of BPD [ 32 ]. Our findings also concur with the results of previous studies and with guidelines recommending that a complete course is optimal for ACS management within one to seven days before birth, even in cases of clinical chorioamnionitis [ 5 , 33 , 34 , 35 ].…”

Association of Antenatal Corticosteroids with Neonatal Outcomes among Very Preterm Infants Born to Mothers with Clinical Chorioamnionitis: A Multicenter Cohort Study

“…Reduction of intrauterine inflammation can decrease dysregulation of growth factors, mesenchymal structural proteins, and signaling pathways, which may slow structural changes in the fetal lung, leading to a reduced risk of BPD [ 32 ]. Our findings also concur with the results of previous studies and with guidelines recommending that a complete course is optimal for ACS management within one to seven days before birth, even in cases of clinical chorioamnionitis [ 5 , 33 , 34 , 35 ].…”

Dynamic Risk‐Stratification Models for Bronchopulmonary Dysplasia in Extremely Preterm Very Low Birth Weight Infants

“…ANCS administration demonstrated a protective association with BPD severity, potentially mediated through multiple mechanisms, including reducing intrauterine inflammation, enhancing surfactant production, stabilizing alveolar structure, minimizing lung injury, and promoting overall pulmonary development. These physiological effects have been correlated with a decreased incidence of BPD in preterm infants [24–27]. The present findings align with those of Greenberg et al who identified ANCS as a significant predictor on postnatal day 1, and with the NEOCOSUR model, which recognized of ANCS as an early predictor of severe BPD or postnatal mortality.…”

Association between antenatal corticosteroid treatment and severe adverse events in pregnant women

“…This study provides real-world evidence that antenatal corticosteroid treatment is not harmless but poses potentially serious health risks to pregnant women. The findings not only reveal the potential risk of sepsis related to antenatal corticosteroid treatment, which is in line with previous studies [ 13 , 18 , 19 ], but also highlight a novel positive association of antenatal corticosteroid treatment with heart failure and gastrointestinal bleeding. Second, our findings suggest that the increased risks of sepsis, heart failure, and gastrointestinal bleeding persist up to 180 days after receipt of antenatal corticosteroid treatment—well into the postpartum period for all the women studied.…”

Association of Antenatal Corticosteroids with Neonatal Outcomes among Very Preterm Infants Born to Mothers with Clinical Chorioamnionitis: A Multicenter Cohort Study

“…Reduction of intrauterine inflammation can decrease dysregulation of growth factors, mesenchymal structural proteins, and signaling pathways, which may slow structural changes in the fetal lung, leading to a reduced risk of BPD [ 32 ]. Our findings also concur with the results of previous studies and with guidelines recommending that a complete course is optimal for ACS management within one to seven days before birth, even in cases of clinical chorioamnionitis [ 5 , 33 , 34 , 35 ].…”

Dynamic Risk‐Stratification Models for Bronchopulmonary Dysplasia in Extremely Preterm Very Low Birth Weight Infants

“…ANCS administration demonstrated a protective association with BPD severity, potentially mediated through multiple mechanisms, including reducing intrauterine inflammation, enhancing surfactant production, stabilizing alveolar structure, minimizing lung injury, and promoting overall pulmonary development. These physiological effects have been correlated with a decreased incidence of BPD in preterm infants [24–27]. The present findings align with those of Greenberg et al who identified ANCS as a significant predictor on postnatal day 1, and with the NEOCOSUR model, which recognized of ANCS as an early predictor of severe BPD or postnatal mortality.…”

Association between antenatal corticosteroid treatment and severe adverse events in pregnant women

“…This study provides real-world evidence that antenatal corticosteroid treatment is not harmless but poses potentially serious health risks to pregnant women. The findings not only reveal the potential risk of sepsis related to antenatal corticosteroid treatment, which is in line with previous studies [ 13 , 18 , 19 ], but also highlight a novel positive association of antenatal corticosteroid treatment with heart failure and gastrointestinal bleeding. Second, our findings suggest that the increased risks of sepsis, heart failure, and gastrointestinal bleeding persist up to 180 days after receipt of antenatal corticosteroid treatment—well into the postpartum period for all the women studied.…”

Association of Antenatal Corticosteroids with Neonatal Outcomes among Very Preterm Infants Born to Mothers with Clinical Chorioamnionitis: A Multicenter Cohort Study

“…Reduction of intrauterine inflammation can decrease dysregulation of growth factors, mesenchymal structural proteins, and signaling pathways, which may slow structural changes in the fetal lung, leading to a reduced risk of BPD [ 32 ]. Our findings also concur with the results of previous studies and with guidelines recommending that a complete course is optimal for ACS management within one to seven days before birth, even in cases of clinical chorioamnionitis [ 5 , 33 , 34 , 35 ].…”

Dynamic Risk‐Stratification Models for Bronchopulmonary Dysplasia in Extremely Preterm Very Low Birth Weight Infants

“…ANCS administration demonstrated a protective association with BPD severity, potentially mediated through multiple mechanisms, including reducing intrauterine inflammation, enhancing surfactant production, stabilizing alveolar structure, minimizing lung injury, and promoting overall pulmonary development. These physiological effects have been correlated with a decreased incidence of BPD in preterm infants [24–27]. The present findings align with those of Greenberg et al who identified ANCS as a significant predictor on postnatal day 1, and with the NEOCOSUR model, which recognized of ANCS as an early predictor of severe BPD or postnatal mortality.…”

Association between antenatal corticosteroid treatment and severe adverse events in pregnant women

“…This study provides real-world evidence that antenatal corticosteroid treatment is not harmless but poses potentially serious health risks to pregnant women. The findings not only reveal the potential risk of sepsis related to antenatal corticosteroid treatment, which is in line with previous studies [ 13 , 18 , 19 ], but also highlight a novel positive association of antenatal corticosteroid treatment with heart failure and gastrointestinal bleeding. Second, our findings suggest that the increased risks of sepsis, heart failure, and gastrointestinal bleeding persist up to 180 days after receipt of antenatal corticosteroid treatment—well into the postpartum period for all the women studied.…”