Antenatal Corticosteroids in the Management of Preterm Birth: Are We Back Where We Started?

Even with recently declining rates, preterm birth remains a critical public health problem. Administration of antenatal corticosteroids to improve outcomes after preterm birth is one of the most important interventions in obstetrics. This article summarizes the evidence for antenatal corticosteroid efficacy and safety. Although antenatal corticosteroids are effective for singleton pregnancies at risk for preterm birth between 26 and 34 weeks' gestation, questions remain regarding the utility in specific cases such as multiple gestations, very early preterm gestations, and pregnancies complicated by intrauterine growth restriction. Uncertainty also remains about length of corticosteroid effectiveness and need for repeat or rescue courses.