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Effect of Corticosteroids for Fetal Maturation on Perinatal Outcomes: NIH Consensus Development Panel on the Effect of Corticosteroids for Fetal Maturation on Perinatal Outcomes
Abstract
OBJECTIVE: To develop a consensus on the use of antenatal corticosteroids for fetal maturation in preterm infants. PARTICIPANTS: A nonfederal, nonadvocate, 16-member consensus panel including representatives from neonatology, obstetrics, family medicine, behavioral medicine, psychology, biostatistics, and the public; 19 experts in neonatology, obstetrics, and pharmacology presented data to the consensus panel and a conference audience of approximately 500. EVIDENCE: An extensive bibliography of references was produced for the consensus panel and the conference audience using a variety of on-line databases including MEDLINE. The consensus panel met several times prior to the conference to review the literature. It also commissioned an updated meta-analysis, a neonatal registry review, and an economic analysis that were presented at the conference. The experts prepared abstracts for distribution at the conference, presented data, and answered questions from the panel and audience. The panel evaluated the strength of the scientific evidence using the grading system developed by the Canadian Task Force on the Periodic Health Examination and adapted by the US Preventive Services Task Force. CONSENSUS: The consensus panel, answering predefined consensus questions, developed their conclusions based on the scientific evidence presented in open forum and the scientific literature. CONSENSUS STATEMENT: The consensus panel composed a draft statement that was read in its entirety at the conference for comment. The panel released a revised statement at the end of the conference and finalized the revisions a few weeks after the conference. CONCLUSIONS: Antenatal corticosteroid therapy is indicated for women at risk of premature delivery with few exceptions and will result in a substantial decrease in neonatal morbidity and mortality, as well as substantial savings in health care costs. The use of antenatal corticosteroids for fetal maturation is a rare example of a technology that yields substantial cost savings in addition to improving health.
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“Glucocorticoids are crucial during fetal development for the functional maturation of the respiratory system [90,91,92] and are currently utilized as the standard of care for women at high risk for preterm delivery to prevent respiratory distress syndrome [93].”
From Stress and the HPA Axis: Balancing Homeostasis and Fertility. (2017) · cites this paper as [93]
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Church, M. W., Adams, B. R., Anumba, J. I., Jackson, D. A., Kruger, M. L., & Jen, K. ‐. C. (2011) · Neurotoxicology and Teratology · doi:10.1016/j.ntt.2011.09.004 · Cited by 23
“Preterm birth and low birth weight are serious health problems because they are associated with increased infant morbidity and mortality [2].”
BackgroundMinguez-Milio, J. A., Alcázar, J., Aubá, M., Ruiz-Zambrana, Á., & Minguez, J. (2011) · Journal of Maternal-Fetal & Neonatal Medicine · doi:10.3109/14767058.2011.552990 · Cited by 24
Been, J. V., Rours, I. G. I. J. G., Kornelisse, R. F., Passos, V. L., Kramer, B. W. W., Schneider, T. A. J., de Krijger, R. R., & Zimmermann, L. J. I. (2009) · American Journal of Obstetrics and Gynecology · doi:10.1016/j.ajog.2009.06.025 · Cited by 129
Metadata
- Authors
- Gilstrap, L. C.
- Affiliations
- National Institutes of Health (US)
- Corresponding author
- Gilstrap, Larry C.
- Venue
- JAMA
- Publisher
- American Medical Association (AMA)
- Published
- 1995-02-01
- Volume
- 273
- Issue
- 5
- Pages
- 413
- ISSN
- 0002-9955 (ISSN-L)
- 0098-7484
- OpenAlex
- W2130559132
- Cited by
- 1,269
- References
- 0
- Citations by year
- 2026: 11 · 2025: 22 · 2024: 21 · 2023: 31 · 2022: 34 · 2021: 31 · 2020: 43 · 2019: 45 · 2018: 35 · 2017: 40 · 2016: 47 · 2015: 38 · 2014: 31 · 2013: 55 · 2012: 53
- FWCI
- 36.53
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- JAMA (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Neonatal Respiratory Health Research
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Infant Development and Preterm Care
- Health Sciences › Medicine › Obstetrics and Gynecology › Preterm Birth and Chorioamnionitis
- Keywords
- antenatal corticosteroids, fetal lung maturation, preterm birth, perinatal outcomes, neonatal morbidity and mortality, health care costs, cost reduction, expert consensus
- MeSH terms
- Adrenal Cortex Hormones, Female, Fetal Organ Maturity, Humans, Infant, Newborn, Infant, Premature, Diseases, Obstetric Labor, Premature, Male, Pregnancy, Treatment Outcome
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