Respiratory distress syndrome (RDS) is one of the major causes of early neonatal mortality and morbidity. In singleton preterm pregnancies, prophylactic corticosteroids accelerate lung maturation and reduce the incidence of RDS. This study aims to investigate the effectiveness of antenatal corticosteroids given at 34 or more week’s gestation.

This systematic review and meta-analysis included six randomized controlled trials comparing antenatal corticosteroids with placebo. The six trials included a total of 5,698 singleton pregnancies. The eligible singleton pregnancies were at ≥34 weeks’ gestation. The primary outcome of the study was the incidence of severe RDS.

The findings suggested that infants of mothers who received antenatal corticosteroids at ≥34 weeks were at a lower risk of RDS (relative risk 0.74), mild RDS (RR 0.67), moderate RDS (0.39), transient tachypnea of the newborn (0.56), and severe RDS (0.55). Infants of mothers who received antenatal betamethasone at 34-36 weeks’ gestation had a lower incidence of transient tachypnea of the newborn (RR 0.72). Infants of mothers who underwent planned cesarean delivery at  ≥37 weeks’ gestation and received prophylactic antenatal corticosteroids were at a lower risk of RDS.

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The research concluded that infants of mothers who received antenatal corticosteroids during all ranges of gestational age were at a lower risk of RDS.

Ref: https://www.bmj.com/content/355/bmj.i5044