Antenatal kortikosteroid uygulamalarinin fetal ve neonatal etkileri

Although antenatal corticosteroids have been used in clinical practice for approximately 30 years to increase fetal lung maturation and decrease to a minimum neonatal morbidity and mortality by preventing the development of respiratory distress syndrome in preterm infants, there is still much controversy about the type of corticosteroid preparation to use, and the dose, frequency and time of administration before delivery. We review and discuss in this article current opinions and developments about the ideal preparation of and optimum time of administration, dose and frequency of antenatal glucocorticoid treatment protocols and their short- and long-term fetal-neonatal adverse effects and complications. It was concluded that a single course of antenatal glucocorticoid treatment significantly reduces respiratory distress syndrome, intraventricular hemorrhage and periventricular leukomalacia; its effect persists beyond seven days after administration; and it can be used safely without any adverse effects in the presence of risk of preterm delivery or when elective preterm delivery is needed between the 24th to 34th gestational weeks. Although antenatal glucocorticoid treatment with weekly (multiple) courses does not have any significant demonstrated maternal or fetal-neonatal adverse effects, it should be considered that it may have potential adverse effects on the central nervous system and neuromotor development. It does not have additional benefits or advantages over single-course antenatal glucocorticoid treatment with respect to fetal lung maturation or neonatal morbidity parameters, and it should not be routinely used except for special indications.