[Perinatal glucocorticosteroid therapy: time for reconsideration]

Abstract

Glucocorticosteroids are administered antenatally and postnatally to decrease pulmonary morbidity of preterm neonates. One course of antenatal corticosteroids decreases mortality, and the frequency of respiratory distress syndrome and intraventricular hemorrhage. However, multiple courses may be associated with impaired brain development. Follow-up studies are needed to assess long-term consequences. The use of betamethasone may be of advantage compared to dexamethasone. Postnatally, steroids are given to treat or prevent bronchopulmonary dysplasia (BPD). However, recent studies have shown that treatment with dexamethasone increases the rate of cerebral palsy in preterm infants. Postnatal treatment of BPD with steroids should be restricted to life-threatening situations.