title: Antenatal steroid administration in medically uncomplicated pregnancy beyond 37 weeks of gestation for the prevention of neonatal morbidities prior to elective caesarean section: a systematic review and meta-analysis of randomised controlled trials.
abstract: BACKGROUND
  Elective caesarean section is associated with an increased risk of respiratory morbidity and admission to special care nursery even at full-term gestation.
  
  
  OBJECTIVE
  To systematically review the efficacy of antenatal steroid administration to prevent neonatal morbidity at full-term. Only randomised and quasirandomised controlled trials were selected.
  
  
  METHODS
  Standardised methodology as described by the Cochrane neonatal review group was used for data collection and analysis.
  
  
  RESULTS
  A total of three randomised controlled trials (N = 2740 patients) were included in the review. Meta-analysis of the published data was carried out. A significant decrease in the risk of respiratory distress syndrome (odds ratio (OR) 0.40 (95%CI: 0.23-0.71, p < 0.001), risk of transient tachypnoea of newborn (OR 0.37 (95%CI: 0.25-0.56, p < 0.00001)), risk of admission to special care nursery (OR 0.53 (95%CI: 0.37-0.76, p < 0.0007)) were observed.
  
  
  CONCLUSIONS
  Although antenatal steroid administration prior to elective caesarean section demonstrated significant benefit in the prevention of neonatal morbidities; however, one need to be cautious before it can be routinely administered because of the paucity of long-term safety data.
authors.affiliation: a Department of Paediatrics , Joondalup Health Campus , Joondalup , Perth , Western Australia , and.|b School of Paediatrics and Child Health, University of Western Australia , Perth , Western Australia.
authors.forename: Ravisha
authors.initials: R
authors.lastname: Srinivasjois
authors.affiliation: a Department of Paediatrics , Joondalup Health Campus , Joondalup , Perth , Western Australia , and.|b School of Paediatrics and Child Health, University of Western Australia , Perth , Western Australia.
authors.forename: Desiree
authors.initials: D
authors.lastname: Silva
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D002585:Cesarean Section / Q000009:adverse effects*; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal / Q000706:statistics & numerical data; D011247:Pregnancy; D016032:Randomized Controlled Trials as Topic; D012127:Respiratory Distress Syndrome, Newborn / Q000517:prevention & control*; D012306:Risk
chemical_list: D000305:Adrenal Cortex Hormones
keywords: Antenatal steroids; elective caesarean section; perinatal mortality; respiratory distress; transient tachypnoea of newborn