Alan H. Jobe MD, PhD and Richard A. Polin, MD
In this episode, “Antenatal Steroids: Which Drugs and Dose?” Dr. Jobe and Dr. Polin deliberate the optimal process of antenatal steroid administration.
Antenatal corticosteroids have been used for decades to optimize neonatal outcomes in preterm deliveries. Although there is robust data to support the use of this therapy, the specific drug type, dose, and route of administration may not be fully understood. Most of the data regarding the efficacy of antenatal corticosteroids comes from studies of high resource environments. We have little data, however, from low resource populations whose baseline characteristics can lead to confounding of neonatal and obstetrical outcomes. Additionally, as new evidence emerges regarding the developmental origins of adult disease, some experts have proposed that the pleotropic effects of fetal corticosteroid exposure may influence outcomes of adult diseases such as strokes and malignancies. A more judicious use of these medications may therefore be warranted.