POEMs

Steroids at 34 to 36 Weeks' and Before Term Cesarean Decrease Respiratory Distress Syndrome

 

Am Fam Physician. 2017 Feb 15;95(4):257.

Clinical Question

Should antenatal steroid treatment be used for women at risk of late premature delivery or women undergoing planned cesarean delivery?

Bottom Line

For women admitted for imminent premature delivery at 34 to 36 weeks of gestation, one or two doses of betamethasone or dexamethasone (8 to 12 mg) decrease the likelihood of neonatal respiratory distress syndrome and shorten lengths of stay in the intensive care unit. One or two doses given to women 48 hours before a planned cesarean delivery at term are also effective in decreasing respiratory distress. Neonatal hypoglycemia is increased, but, as shown in a separate study, there is no long-term harm with treatment, at least up to six to eight years of age (Pediatrics. 2016;138(4):e20160947). (Level of Evidence = 1a)

Synopsis

Although steroids

POEMs (patient-oriented evidence that matters) are provided by EssentialEvidence Plus, a point-of-care clinical decision support system published by Wiley-Blackwell. For more information, please see http://www.essentialevidenceplus.com. Copyright Wiley-Blackwell. Used with permission.

For definitions of levels of evidence used in POEMs, see http://www.essentialevidenceplus.com/product/ebm_loe.cfm?show=oxford.

To subscribe to a free podcast of these and other POEMs that appear in AFP, search in iTunes for “POEM of the Week” or go to http://goo.gl/3niWXb.

This series is coordinated by Sumi Sexton, MD, Associate Deputy Editor.

A collection of POEMs published in AFP is available at http://www.aafp.org/afp/poems.


 

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