Retrospective analysis on the efficacy of corticosteroid prophylaxis prior to elective caesarean section to reduce neonatal respiratory complications at term of pregnancy: review of literature.
OBJECTIVE
Our purpose was to conduct a systematic review of the literature to determine whether synthetic pharmaceutical glucocorticoids (betamethasone and dexamethasone) are safe as well as effective in reducing neonatal respiratory morbidity at term of pregnancy prior to elective caesarean section. The overall incidence of respiratory disorders is estimated at 2.8%, and the main risk factors are gestational age and mode of delivery. Newborns delivered by elective caesarean section (CS after 37 weeks) are more susceptible to serious respiratory complications than babies born by vaginal delivery. Neonatal respiratory morbidity at term of pregnancy is low but not negligible. Further, it is increasing due to a drastic decline in trial of labour in those pregnant women who underwent a caesarean section in the past. Because prophylaxis is inexpensive, easy to administer, and safe, other studies should be conducted to confirm its effectiveness.


METHODS
We conducted a systematic review of literature since 1965 on the discovery of action mechanisms, pharmaceutical development, proper dosage, and potential side effects of corticosteroids on the mother and offspring to extrapolate their efficacy as no clinical trial has directly demonstrated it.


RESULTS
We extrapolated no negative effects on mother and foetus behaviour.


CONCLUSIONS
Human studies suggest that corticosteroid administration may become a proper clinical indication prior to caesarean section in the reduction of neonatal respiratory problems.
Department of Obstetrics and Gynecology, Arcispedale S. Maria Nuova, Istituto Tecnologie Avanzate e Modelli Assistenziali in Oncologia, IRCCS, Azienda Santa Maria Nuova, Viale Risorgimento, 80, 42123, Reggio Emilia, Italy, simone.paganelli@asmn.re.it.
Simone
S
Paganelli
Emanuele
E
Soncini
Giancarlo
G
Gargano
Francesco
F
Capodanno
Cristina
C
Vezzani
Giovanni Battista
GB
La Sala
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D001623:Betamethasone / Q000627:therapeutic use*; D002585:Cesarean Section / Q000009:adverse effects*; D036861:Delivery, Obstetric / Q000379:methods / Q000706:statistics & numerical data; D003907:Dexamethasone / Q000627:therapeutic use; D005260:Female; D005865:Gestational Age; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D009017:Morbidity; D011247:Pregnancy; D012127:Respiratory Distress Syndrome, Newborn / Q000453:epidemiology / Q000517:prevention & control*; D012189:Retrospective Studies; D012307:Risk Factors
D000305:Adrenal Cortex Hormones; D005938:Glucocorticoids; D003907:Dexamethasone; D001623:Betamethasone