Contemporary Challenges and Developments: Antenatal Corticosteroid Therapy

AbstractPurpose of ReviewThe purpose of this review is to (i) provide an update to the current challenges surrounding the use of antenatal corticosteroids (ACS) and (ii) to provide a brief synthesis of recent findings relating to work to optimize the efficacy and safety and of ACS therapy to better understand its short- and long-term impacts on the developing foetus.Recent FindingsThere are numerous human and experimental animal studies describing the impact of ACS exposure on foetal growth and programming, in particular, changes to the cardiovascular, endocrine and central nervous systems. Moreover, recent studies have reported adverse impacts on brain development and potential risk of neurological disorders in term-born infants unnecessarily exposed to a single course of ACS. Of particular interest are recent studies describing the potential for transgenerational transmission of ACS-induced effects.SummaryWhen administered to the right women at the right time, ACS are an effective therapy to mature lung function and circulatory stability in preterm infants. Their judicious use reduces neonatal mortality and morbidity. However, much remains to be understood with regard to the optimal use of ACS. Current challenges in the field relate to the limited durability of lung maturation following ACS treatment, the difficulty in predicting preterm delivery and thus the optimal timing of ACS administration. Furthermore, despite some 50  years of clinical use, there has been little in...
Source: Current Obstetrics and Gynecology Reports - Category: OBGYN Source Type: research