Repeat antenatal glucocorticoids for women at risk of preterm birth: A Cochrane Systematic Review

Christopher J.D. McKinlay, Caroline A. Crowther, Philippa Middleton, Jane E. Harding

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67 Citations (Scopus)

Abstract

Administration of antenatal glucocorticoids to women at risk of preterm birth has major benefits for infants but the use of repeat dose(s) is controversial. We performed a systematic review of randomized trials, using standard Cochrane methodology, to assess the effectiveness and safety of 1 or more repeat doses given to women at risk of preterm birth 7 or more days after an initial course. Ten trials were included involving over 4730 women and 5700 infants. Treatment with repeat dose(s) compared with no repeat treatment reduced the risk of respiratory distress syndrome (risk ratio, 0.83; 95% confidence interval, 0.750.91) and serious neonatal morbidity (risk ratio, 0.84; 95% confidence interval, 0.750.94). At 2- to 3-year follow-up (4 trials, 4170 children), there was no evidence of either significant benefit or harm. Repeat doses of glucocorticoids should be considered in women at risk of preterm birth 7 or more days after an initial course, in view of the neonatal benefits.

Original languageEnglish
Pages (from-to)187-194
Number of pages8
JournalAmerican Journal of Obstetrics and Gynecology
Volume206
Issue number3
DOIs
Publication statusPublished or Issued - Mar 2012
Externally publishedYes

Keywords

  • prenatal corticosteroids
  • repeat antenatal glucocorticoids
  • respiratory distress syndrome
  • systematic review

ASJC Scopus subject areas

  • Obstetrics and Gynaecology

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