title: Antenatal corticosteroids for periviable birth.
abstract: Antenatal corticosteroids have been proven to accelerate fetal lung development and reduce neonatal morbidity and mortality when given between 28 and 34 weeks of gestation. However, there is only limited research to guide their use in the periviable period (22-26 weeks). Laboratory studies suggest that it is biologically plausible for antenatal steroids to be effective in this gestational period. In addition, cohort studies have demonstrated the efficacy of antenatal corticosteroids in reducing neonatal mortality and IVH. Follow-up studies performed between 18 and 22 months of age also suggest a long-term benefit to antenatal use in this period. Based on this information, antenatal corticosteroids should be used in appropriate patients at high risk for preterm birth at 23-26 weeks of gestation. An advantageous outcome to treatment at 22 weeks is less certain.
authors.affiliation: Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Columbia University Medical Center, 622 W. 168th St, New York, NY 10032. Electronic address: rw2191@columbia.edu.
authors.forename: Ronald J
authors.initials: RJ
authors.lastname: Wapner
mesh_terms: D000305:Adrenal Cortex Hormones / Q000008:administration & dosage / Q000627:therapeutic use*; D001623:Betamethasone / Q000008:administration & dosage; D003907:Dexamethasone / Q000008:administration & dosage; D005260:Female; D005328:Fetal Viability; D005500:Follow-Up Studies; D006801:Humans; D062071:Infant, Extremely Premature; D007231:Infant, Newborn; D008168:Lung / Q000187:drug effects / Q000196:embryology / Q000254:growth & development*; D011247:Pregnancy; D011262:Pregnancy Trimester, Second; D011295:Prenatal Care; D013997:Time Factors
chemical_list: D000305:Adrenal Cortex Hormones; D003907:Dexamethasone; D001623:Betamethasone
keywords: Antenatal corticosteroids; Betamethasone; Periviable birth