Editorials

Antenatal corticosteroids for women at risk of preterm delivery

BMJ 2017; 356 doi: https://doi.org/10.1136/bmj.j1467 (Published 28 March 2017) Cite this as: BMJ 2017;356:j1467
  1. Sarah D McDonald, professor and Canada Research chair
  1. Departments of Obstetrics and Gynecology, Radiology, and Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada, L8S 4K1
  1. mcdonals{at}mcmaster.ca

Timing is critical to maximising benefits for very premature babies

The administration of antenatal corticosteroids to women at risk of early preterm birth has been one of the most effective interventions to improve premature infants’ outcomes, reducing death and serious morbidities in randomised trials and meta-analyses. For women at risk of delivery before 34 weeks gestational age, clinical practice guidelines advocate injection of 12 mg of betamethasone followed by a repeat injection 24 hours later.1 Recent guidelines also recommended antenatal steroids for women at risk of delivering a 23 week infant, when resuscitation is desired.23

In their large retrospective observational study (doi:10.1136/bmj.j1039), Travers and colleagues studied an American cohort of neonates born between 23 and 34 weeks of gestation.4 Slightly more than 60% of 23 week infants received antenatal steroids, and the proportions increased to approximately 80% between 24 and 32 weeks, before decreasing to …

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