Antenatal steroids for fetal lung maturation

  • Corticosteroids are a type of medication given to you to help your baby if there is a possibility of having your baby early. Corticosteroids are given by an injection into the muscle usually of your thigh or upper arm. A single course can consist of two injections usually over a 24–48-hour period.
  • Antenatal betamethasone (steroids) is used to speed up lung development in preterm fetuses. It stimulates the synthesis and release of surfactant which helps in maturity of the lung of fetuses.
Cortico steroid

Cortico steroid

Surfactant, released after injection of corticosteroids helps in preventing alveoli to collapse

Surfactant, released after injection of corticosteroids helps in preventing alveoli to collapse

  • Corticosteroids have been used for many years in women who are thought to have a high chance of having their baby early. Premature babies (born before 37 weeks) have an increased risk of health problems, particularly with breathing, feeding and infection. These problems tend to be more severe the earlier the baby is born.
  • When pregnant women are given corticosteroid injections, the medication travel to the baby’s body and lungs through their blood, which can speed up the development of the baby’s lungs a lot. This gives many preterm babies a much better chance of survival by increasing lung maturity.
  • A single course of corticosteroids has been shown to help with a baby’s development and therefore will increase the chance of your baby surviving, once born. It also lessens the chance of your baby having serious complications after birth:
    • Such as breathing problems.
    • Bleeding into the brain.
    • Bowel inflammation.

  • A single / double course of two to four injections is considered to be safe for you and your baby.

  • Corticosteroids help most if they are given to you between 24 weeks to 35 weeks of pregnancy.
  • If you are having a planned caesarean section, corticosteroids are usually recommended.

  • Corticosteroids are of most help if the last dose is given to you 24 hours before you have your baby. There may still be benefit even if your baby is born within 24 hours of the first dose.

  • You may be advised to have corticosteroids if there is an increased chance that your baby will be born before 35 weeks of pregnancy. This includes:

    • If you have history of preterm birth in previous pregnancy.
    • If you are in premature labour.
    • If your waters break even if you are not having contractions. PROM
    • If you have short cervix in ultra sonography.
    • If you have undergone Cervical stitch ( OS Wiring / Nylon wiring ) .
    • If baby is required to be delivered early either because of fetal, maternal reason.
    • Fetal : if baby is not growing well ( IUGR baby ).
    • Maternal : Mother is seriously unwell , have high BP , severe pre eclampsia

  • If you are having a planned caesarean, corticosteroids are recommended to lessen the chance of breathing problems for your baby.

  • If you have diabetes or gestational diabetes, corticosteroids increase the blood sugar level temporally for few hrs. Your doctor may adjust the dose of tablets / Injection temporally.

  • Corticosteroids can suppress the mother’s immune system, but there is no evidence that a single course of corticosteroids will cause harm even if you have a severe infection.

This information aims to helps you make the best decision regarding your care. It is not meant to replace advice from a doctor about your own situation.