Editorials

Recent guidance on antenatal corticosteroids in prematurity

BMJ 2016; 352 doi: https://doi.org/10.1136/bmj.i1655 (Published 23 March 2016) Cite this as: BMJ 2016;352:i1655
  1. Melissa K Whitworth, consultant obstetrician
  1. St Mary’s Hospital, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester M13 9WL
  1. melissa.whitworth{at}cmft.nhs.uk

The big problem remains deciding who is in genuine preterm labour

Preterm birth—birth before 37 weeks of pregnancy—is the leading cause of perinatal and neonatal mortality and morbidity. Globally, 15 million babies are born preterm each year; for England and Wales the figure is around 50 000, costing the UK economy almost £1bn a year.1

Maternal antenatal corticosteroids are one of the most effective obstetric interventions to reduce neonatal morbidity and mortality in premature babies. The most recent Cochrane review of this treatment, a meta-analysis of 21 randomised trials including 4269 women, reported that neonatal respiratory distress syndrome occurred in 17.3% of the group receiving corticosteroids compared with 26% of the control group and that neonatal mortality was 10.1% in the corticosteroid group compared with 14.8% in the control group.2 This and other benefits have led to a focus on ensuring that corticosteroids are administered promptly.

Last year the World Health Organization (WHO) and the UK National Institute for Health and Care Excellence (NICE) …

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