In this episode Dr. Øystein Bergøy discusses the evidence behind the risks of antenatal corticosteroids for women at risk for preterm delivery.
- ACOG guidelines on fetal maturation
- NICE guidelines on risk of premature labour
- Norwegian guidelines on risk of premature labour
- 2015 cochrane analysis of repeat steroids
- Study were microsimulation was used to make a ratio of benefits vs harms of repeat steroids according to gestational age at birth
- Uptodate.com article on antenatal steroids
- study showing increased rds 1 to 24 hrs after booster dose
- Review from Nature in 2001 mentioning several animall studies that show negative effects of excess corticosteroids in utero
- Animal study from Kidney Int from 2000 showing increased risk of glucose intolerance with exogenous corticosteroid exposure in utero
- Study in baboons from Nature in 2012 showing impaired myelination after exposure to repeat antenatal steroids
- 3 studies that have shown impaired stress response inneonates exposed to antenatal steroids
- https://www.ncbi.nlm.nih.gov/pubmed/?term=Antenatal+betamethasone+administration+alters+stress+physiology+in+healthy+neonates
- https://www.ncbi.nlm.nih.gov/pubmed/?term=Effects+of+prenatal+betamethasone+exposure+on+regulation+of+stress+physiology+in+healthy+premature+infants
- https://www.ncbi.nlm.nih.gov/pubmed/?term=Neonatal+adrenal+function+after+repeat+dose+prenatal+corticosteroids%3A+a+randomized+controlled+trial
- https://www.ncbi.nlm.nih.gov/pubmed/?term=Multiple+courses+of+antenatal+corticosteroids+and+outcome+of+premature+neonates.+North+American+Thyrotropin-Releasing+Hormone+Study+Group
- Study showing impaired HPA function in children 6-11 years of age exposed to antenatal steroids
- Study showing signs of glucose intolerance in participant who received antenatal steroids compared to placebo
- Study showing increased aortic stiffness in those exposed to antenatal steroids
- crowther et al mid childhood neurocgognitive development
- meta analysis from 2016 in BMJ examining benefits and harms of antenatal steroids between 34 and 36 weeks gestation