Antenatal corticosteroids for women at risk of preterm delivery

The administration of antenatal corticosteroids to women at risk of early preterm birth has been one of the most effective interventions to improve premature infants’ outcomes, reducing death and serious morbidities in randomised trials and meta-analyses. For women at risk of delivery before 34 weeks gestational age, clinical practice guidelines advocate injection of 12 mg of betamethasone followed by a repeat injection 24 hours later.1 Recent guidelines also recommended antenatal steroids for women at risk of delivering a 23 week infant, when resuscitation is desired.23

In their large retrospective observational study (doi:10.1136/bmj.j1039), Travers and colleagues studied an American cohort of neonates born between 23 and 34 weeks of gestation.4 Slightly more than 60% of 23 week infants received antenatal steroids, and the proportions increased to approximately 80% between 24 and 32 weeks, before decreasing to …