Antenatal steroid administration in medically uncomplicated pregnancy beyond 37 weeks of gestation for the prevention of neonatal morbidities prior to elective caesarean section: a systematic review and meta-analysis of randomised controlled trials

Ravisha Srinivasjois, Desiree Silva

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    6 Citations (Scopus)

    Abstract

    Background: Elective caesarean section is associated with an increased risk of respiratory morbidity and admission to special care nursery even at full-term gestation. Aim: To systematically review the efficacy of antenatal steroid administration to prevent neonatal morbidity at full-term. Only randomised and quasirandomised controlled trials were selected. Methods: Standardised methodology as described by the Cochrane neonatal review group was used for data collection and analysis. Results: A total of three randomised controlled trials (N = 2740 patients) were included in the review. Meta-analysis of the published data was carried out. A significant decrease in the risk of respiratory distress syndrome (odds ratio (OR) 0.40 (95%CI: 0.23–0.71, p < 0.001), risk of transient tachypnoea of newborn (OR 0.37 (95%CI: 0.25–0.56, p < 0.00001)), risk of admission to special care nursery (OR 0.53 (95%CI: 0.37–0.76, p < 0.0007)) were observed. Conclusion: Although antenatal steroid administration prior to elective caesarean section demonstrated significant benefit in the prevention of neonatal morbidities; however, one need to be cautious before it can be routinely administered because of the paucity of long-term safety data.
    Original languageEnglish
    Pages (from-to)1151-1157
    Number of pages7
    JournalJournal of Maternal-Fetal and Neonatal Medicine
    Volume30
    Issue number10
    Early online date2016
    DOIs
    Publication statusPublished - 19 May 2017

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