Overview
Antenatal corticosteroids (ACS) are used to promote fetal lung maturation. Multiple courses of ACS, including rescue doses or courses, have been studied for their long-term effects compared to a single course.Diagnosis
Management
Special Populations
Pregnancy: Multiple courses of ACS versus a single course have been associated with mild respiratory benefits but also adverse outcomes such as smaller head circumference and birth weight 1. Long-term effects warrant further study 1.
Pediatrics: Among children born preterm, randomization to multiple courses versus a single course of ACS was not associated with adjusted beneficial or adverse neurodevelopmental/psychological or other outcomes, but data are scant after a rescue dose and nonexistent after a rescue course 1. For children born at term, preterm randomization to multiple courses (at least one additional course) versus a single course was significantly associated with... 1.Key Recommendations
Multiple courses of antenatal corticosteroids (ACS) versus a single course have been associated with mild respiratory benefits but also adverse outcomes like smaller head circumference and birth weight 1.
Among preterm births, multiple courses of ACS were not associated with adjusted beneficial or adverse neurodevelopmental/psychological or other outcomes compared to a single course, though data are limited for rescue doses and nonexistent for rescue courses 1.
Long-term effects of multiple versus single courses of ACS warrant further study 1.References
1 Ninan K, Liyanage SK, Murphy KE, Asztalos EV, McDonald SD. Long-Term Outcomes of Multiple versus a Single Course of Antenatal Steroids: A Systematic Review. American journal of perinatology 2024. link