Current evidence for prenatal and postnatal corticosteroids in preterm infants

The review article looks at the current evidence for steroids in preterm infants, both pre- and postnatally. Antenatal corticosteroids undoubtedly save many lives and improve the quality of many others. However, the currently accepted dosage schedule has been in place since 1972, and recent studies have suggested that beneficial effects may be seen with less. Most but not all studies of long-term outcome show no adverse effects. The use of antenatal corticosteroids in women with COVID-19 raises important questions regarding potential risks and benefits. However, currently, most authorities recommend continuing according to published guidelines. With regard to postnatal corticosteroids, alternatives to systemic dexamethasone, the somewhat tainted standard of care, show promise in preventing bronchopulmonary dysplasia without adverse effects. Systemic hydrocortisone and inhaled corticosteroids are of note. The mixture of surfactant and corticosteroids deserves particular attention in the coming years.

Automated summary

The review article examines the current evidence for steroids in preterm infants, with antenatal corticosteroids saving lives and improving quality of life. Recent studies suggest beneficial effects may be seen with lower dosages, while most long-term outcome studies show no adverse effects. The use of antenatal corticosteroids in women with COVID-19 raises important questions, but current guidelines recommend continuing use. Alternative postnatal corticosteroids show promise in preventing bronchopulmonary dysplasia, with a combination of surfactant and corticosteroids being an area of interest for future research.