Choice and dose of corticosteroid for antenatal treatments
Abstract
Although antenatal glucocorticoids are standard of care for women at risk of preterm delivery before 32 to 34 weeks' gestation, the choice and dosing of the corticosteroid has not been standardized. An analysis of the trial data demonstrates that the risk of neonatal death is decreased with betamethasone, but not dexamethasone. Other clinical data also indicate that betamethasone is the drug of choice for antenatal treatment. The pharmacology of the corticosteroids suggests that a lower total glucocorticoid dose per treatment may be as effective as the current treatment recommendations. However, a change from current practice will require further randomized controlled trials.
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Typically, antenatal corticosteroids are administered as two intramuscular injections of 12 mg betamethasone given 24 h apart or alternatively, four doses of 6 mg dexamethasone administered every 12 h to accelerate foetal lung maturation in anticipation of preterm delivery.
“Typically, ACS are administered as two intramuscular injections of 12 mg betamethasone given 24 h apart or alternatively, four doses of 6 mg dexamethasone administered every 12 h to accelerate foetal lung maturation in anticipation of preterm delivery. 40 , 41 , 42”
From A systematic review of glucocorticoid use in type 1 diabetes: Glycaemic effects and clinical management strategies (2026) · cites this paper as [42]
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Katz, A., Shulkin, A., Housni, A., Roy‐Fleming, A., Rabasa‐Lhoret, R., Yale, J., Tsoukas, M. A., Peters, T. M., & Brazeau, A. (2026) · Diabetes, Obesity and Metabolism · doi:10.1111/dom.70465 · Cited by 3 · see citing works
- Authors
- Jobe, A. H., & Soll, R. F.
- Affiliations
- Cincinnati Children's Hospital Medical Center (US)
- University of Vermont (US)
- Venue
- American Journal of Obstetrics and Gynecology
- Publisher
- Elsevier BV
- Published
- 2004-04
- Volume
- 190
- Issue
- 4
- Pages
- 878-881
- ISSN
- 0002-9378 (ISSN-L)
- OpenAlex
- W2058239750
- Cited by
- 213
- References
- 28
- Citations by year
- 2026: 3 · 2025: 2 · 2024: 4 · 2023: 3 · 2022: 7 · 2021: 4 · 2020: 6 · 2019: 8 · 2018: 11 · 2017: 7 · 2016: 16 · 2015: 5 · 2014: 12 · 2013: 6 · 2012: 14
- FWCI
- 15.78
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- Locations
- American Journal of Obstetrics and Gynecology (publishedVersion)
- PubMed (publishedVersion)
- UWA Profiles and Research Repository (UWA) (submittedVersion)
- Funders
- National Heart, Lung, and Blood Institute (HL65397, R01HL065397)
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (HD-12714, R01HD012714)
- 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 › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
- Keywords
- antenatal corticosteroids, betamethasone, dexamethasone, preterm birth, glucocorticoid dose, neonatal death
- MeSH terms
- Betamethasone, Dexamethasone, Female, Fetal Organ Maturity, Glucocorticoids, Humans, Obstetric Labor, Premature, Lung, Pregnancy, Pregnancy Trimester, Third, Prenatal Care, Randomized Controlled Trials as Topic
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