How Do Antenatal Corticosteroids Work?
ACS work by promoting the maturation of the fetal lungs and other organs. They stimulate the production of surfactant, a substance that reduces surface tension in the lungs, thereby enhancing the ability of the lungs to expand and contract effectively. This is crucial for preterm infants who often lack sufficient surfactant, leading to respiratory issues.
When Are Antenatal Corticosteroids Administered?
ACS are typically administered between 24 and 34 weeks of gestation when preterm birth is imminent or likely. The standard regimen involves two doses of betamethasone 24 hours apart or four doses of dexamethasone 12 hours apart. If delivery does not occur within seven days, a repeat course may be considered under specific conditions.
Risks and Side Effects
While ACS are generally safe, they can have side effects. Potential risks include maternal hyperglycemia, increased risk of infection, and, in some cases, reduced fetal growth. However, the benefits often outweigh these risks, particularly in preventing severe neonatal complications.Impact on Long-term Outcomes
Studies have shown that infants exposed to ACS have better long-term outcomes compared to those who are not. They are less likely to suffer from chronic lung disease, developmental delays, and other long-term health issues. However, ongoing research is needed to fully understand the long-term implications.Conclusion
Antenatal corticosteroids play a critical role in neonatal care, particularly for preterm infants. By enhancing fetal lung maturity, they significantly reduce the risk of severe complications and improve both short-term and long-term outcomes. While there are some risks associated with their use, the benefits generally outweigh these concerns, making ACS an essential tool in modern obstetric practice.
