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J Dev Orig Health Dis. 2015 Apr;6(2):127-42. doi: 10.1017/S2040174414000579. Epub 2014 Dec 3.

Antenatal glucocorticoids: where are we after forty years?

Author information

1
1Liggins Institute,The University of Auckland,Auckland,New Zealand.
2
2Children's Emergency Department,Starship Children's Health,Auckland,New Zealand.

Abstract

Since their introduction more than forty years ago, antenatal glucocorticoids have become a cornerstone in the management of preterm birth and have been responsible for substantial reductions in neonatal mortality and morbidity. Clinical trials conducted over the past decade have shown that these benefits may be increased further through administration of repeat doses of antenatal glucocorticoids in women at ongoing risk of preterm and in those undergoing elective cesarean at term. At the same time, a growing body of experimental animal evidence and observational data in humans has linked fetal overexposure to maternal glucocorticoids with increased risk of cardiovascular, metabolic and other disorders in later life. Despite these concerns, and somewhat surprisingly, there has been little evidence to date from randomized trials of longer-term harm from clinical doses of synthetic glucocorticoids. However, with wider clinical application of antenatal glucocorticoid therapy there has been greater need to consider the potential for later adverse effects. This paper reviews current evidence for the short- and long-term health effects of antenatal glucocorticoids and discusses the apparent discrepancy between data from randomized clinical trials and other studies.

KEYWORDS:

developmental origins of health and disease

PMID:
25466556
DOI:
10.1017/S2040174414000579
[Indexed for MEDLINE]

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