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Current evidence for prenatal and postnatal corticosteroids in preterm infants
  1. Eric S Shinwell1,2,
  2. Polina Gurevitz1,
  3. Igor Portnov1
  1. 1Neonatology, Ziv Medical Center, Tzfat, Israel
  2. 2Azrieli Faculty of Medicine, Bar-Ilan University, Tzfat, Israel
  1. Correspondence to Professor Eric S Shinwell, Neonatology, Ziv Medical Center, Tzfat 13100, Israel; eric.s{at}ziv.health.gov.il

Abstract

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.

  • neonatology
  • pharmacology

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Footnotes

  • Contributors ESS conceived and wrote the first and final drafts. PG collated data on postnatal steroids and edited the manuscript. IP collated data on antenatal steroids and edited the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Commissioned; externally peer reviewed.

  • Data availability statement Data are available in a public, open access repository.

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