Antenatal corticosteroids in adequately equipped facilities in low-resource settings

Abstract

The use of antenatal corticosteroids for the prevention of morbidity and mortality in preterm neonates is one of the clearest advances made in obstetric care over the past 50 years. The earliest evidence synthesis showing a reduction in mortality after administration of antenatal corticosteroids in newborn babies is immortalised in the logo of the Cochrane Library,1 and it is now the standard of care for women at risk of imminent preterm birth (<34 weeks of gestation) in high-income countries. However, there has been extensive debate on the suitability of antenatal corticosteroids in the context of low-resource settings,2 with several notable concerns, including their use in health facilities with minimal or no neonatal intensive care facilities and in settings where accurate information on gestational age is unavailable to ensure that antenatal corticosteroids are targeted appropriately.