The Impact of Type, Dosage and Time of Prenatal Steroid Administration on Neonatal Outcome

Background: In 1972, Liggins and Howie demonstrated that antenatal steroid administration reduced the incidence of respiratory distress syndrome and perinatal mortality in neonates. Since the publication of these findings, perinatal and long-term results of steroid therapy have been evaluated in numerous studies. The aim of the review was to compare the impact of type, dosage, and time of prenatal steroid administration on perinatal outcomes in neonates and in mothers. Summary: Although the results of the studies are ambiguous, one should consider the potential benefits of dexamethasone in cases of risk of preterm delivery due to abnormalities in fetal health assessments. Dexamethasone may also lead to better results when preterm neonates are burdened with cardiovascular defects or diseases. The opposite holds true for abnormal flows within UA or fetal MCA, i.e., one should consider whether betamethasone is the appropriate drug of choice. Steroid treatment after 34 weeks of gestation is not beneficial. Administration of the full course of steroid treatment (24 mg) in lower single doses is probably more favorable for the mother. On the other hand, a shorter time interval between the doses may allow more women in preterm birth to receive the full course of steroids. Further studies are required to answer these questions, and better methods for predicting preterm birth should be determined.