Maternal administration of glucocorticoids.
No definite comment can be made, at this time, with respect to the safety of glucocorticoid therapy in the human fetus and newborn. Obstetricians and pediatricians need to be aware of the potential risks. Whether the fetal changes that have been reported thus far are permanent and whether they will have any postnatal functional significance are questions of major importance. Probably the greatest risk associated with antenatal steroid therapy is the potential abuse of this treatment. Longer treatment periods or higher doses of steroids will increase the risk for potentially adverse side effects. The recently stated opinion of Taeusch et al seems appropriate: "We conclude that steroids are effective in reducing risk of RDS, but safer and more efficacious approaches for the prevention of RDS should be sought" (91). Further studies are needed to determine the mechanisms of action of glucocorticoids and their risk/benefit ratios in regard to fetal and neonatal well being.
D000818:Animals; D005260:Female; D005313:Fetal Death / Q000139:chemically induced; D005865:Gestational Age; D005938:Glucocorticoids / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D006801:Humans; D006854:Hydrocortisone / Q000627:therapeutic use; D007231:Infant, Newborn; D008431:Maternal-Fetal Exchange; D010713:Phosphatidylcholines / Q000502:physiology; D011247:Pregnancy; D011650:Pulmonary Alveoli / Q000187:drug effects*; D011663:Pulmonary Surfactants / Q000502:physiology; D011965:Receptors, Glucocorticoid / Q000502:physiology; D012127:Respiratory Distress Syndrome, Newborn / Q000517:prevention & control*; D013329:Structure-Activity Relationship
D005938:Glucocorticoids; D010713:Phosphatidylcholines; D011663:Pulmonary Surfactants; D011965:Receptors, Glucocorticoid; D006854:Hydrocortisone