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Single versus multiple antenatal steriods in threatened preterm delivery?
  1. Gusztav BELTEKI
  1. Cambridge University Hospitals NHS Trust, United Kingdom
    1. Gordon C Smith (gcss2{at}
    1. Cambridge University, United Kingdom


      The first demonstration that antenatal maternal glucocorticoid treatment reduced neonatal morbidity was reported by Liggins and colleagues in 1972 (1). In the following two decades antenatal corticosteroid prophylaxis gradually found its way into clinical practice and became an accepted part of the standard care by the early nineties (2,3). It clearly reduces overall neonatal mortality, the risk of respiratory distress syndrome (RDS) and the need for respiratory support (4). It also decreases the risk of other complications of prematurity, including intraventricular haemorrhage (IVH) and necrotizing enterocolitis (NEC), but not bronchopulmonary dysplasia (BPD). The current recommendation is to give two doses of 12 mg betamethasone, 24 hours apart, to women who may deliver within seven days and are less than 35 weeks pregnant (5,6,7). Most benefit is seen when delivery follows the second dose by more than 24 hours; however, even an incomplete course reduces neonatal morbidity and mortality (8).

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