Evidence from multicenter networks on the current use and effectiveness of antenatal corticosteroids in low birth weight infants

Corticosteroids administered before birth appear to greatly reduce the risk of death and disease among in premature infants, although these hormones are not widely used. The National Institute of Child Health and Development Neonatal Research Network registry of 5,123 infants from seven sites during 1988 to 1991 was studied. Antenatal corticosteroids lowered the risk of death before 28 days and before hospital discharge. The incidence of intraventricular hemorrhage (IVH) ranged from 25% to 46% among infants not treated with the steroids. Among the infants treated with steroids, marked reductions in IVH risk were noted. The risk of pulmonary disease, including respiratory distress syndrome and bronchopulmonary dysplasia, also was lowered. Steroid use, however, increased the risk of sepsis, except for early sepsis, which was decreased. Antenatal corticosteroids are used only in about 20% of women whose babies could benefit from the treatment. Wider use is advised.