Addressing the long-term risks of administering antenatal steroids

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dc.coverageDOI: 10.1080/14656566.2025.2475190
dc.creatorCarter, Sean W.D.
dc.creatorBiswas, Agnihotri
dc.creatorWatson, Hannah R.S.
dc.creatorIp, Han Lin Chelsea
dc.creatorFee, Erin L.
dc.creatorSeah, Kay Yi Michelle
dc.creatorKumagai, Yusaku
dc.creatorAmin, Zubair
dc.creatorChoolani, Mahesh A.
dc.creatorJobe, Alan H.
dc.creatorIllanes, Sebastian E.
dc.creatorKemp, Matthew W.
dc.date2025
dc.date.accessioned2025-11-18T19:50:53Z
dc.date.available2025-11-18T19:50:53Z
dc.description<p>Introduction: A single course of antenatal steroid (ANS) therapy is standard of care for women at risk of preterm birth, reducing the risk of neonatal respiratory distress syndrome, neonatal morbidity, and mortality. An unresolved challenge relates to the potential risk of adverse long-term effects, and how these risks might be balanced with therapeutic benefit. Areas covered: We outline key concepts in glucocorticoid signaling, pharmacokinetics/pharmacodynamics, and clinical use before presenting data on the potential long-term harms of ANS therapy. Expert opinion: Our assessment is that: i) Currently used, high dose ANS regimens can induce multi-system changes in the fetus that alter growth and development, potentially increasing long-term disease risk; and ii) relative risks likely increase proportionally to the magnitude and duration of steroid exposure, in late preterm and term ANS use, and in off-target treatments. A single course of ANS therapy to at risk women between 24- and 34-weeks’ gestation is well justified. Efforts should be made to improve dosing and patient selection. At periviable gestations, the high immediate risk of serious disease or death justifies modest long-term risks. At late preterm and term gestations, where steroids do not provide notable survival or health benefits, supporting routine ANS use is more difficult.</p>eng
dc.identifierhttps://investigadores.uandes.cl/en/publications/4a3a0c3c-f63b-4700-aa27-b0681304f001
dc.identifier.urihttps://repositorio.uandes.cl/handle/uandes/56860
dc.languageeng
dc.rightsinfo:eu-repo/semantics/restrictedAccess
dc.sourcevol.26 (2025) nr.5 p.617-629
dc.subjectAntenatal steroids
dc.subjectadverse effects
dc.subjectdevelopment
dc.subjectfetal
dc.subjectgrowth restriction
dc.subjectneurodevelopment
dc.subjectpreterm birth
dc.subjectprogramming
dc.titleAddressing the long-term risks of administering antenatal steroidseng
dc.typeReview articleeng
dc.typeArtículo de revisiónspa
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