Antenatal Corticosteroids and Neonatal Respiratory Outcomes in Late Preterm Deliveries

Abstract

Introduction: Late preterm infants (34–36 weeks) are at increased risk for transient tachypnea and respiratory distress syndrome. Antenatal corticosteroids (ACS) are standard for earlier gestations, but their efficacy in late prematurity remains debated.
Methods: A systematic literature review was conducted using PubMed, Cochrane Library, and Scopus. Inclusion criteria were randomized controlled trials and cohort studies comparing ACS versus placebo in late preterm singleton pregnancies. Primary outcome was neonatal respiratory morbidity. Quality was assessed with GRADE.
Results: Fifteen studies were included. ACS administration significantly reduced the need for respiratory support (relative risk 0.72) and shortened neonatal intensive care unit stays by a mean of 1.8 days. No significant increase in maternal infection or neonatal hypoglycemia was found. Heterogeneity was moderate.
Discussion: The benefits of ACS in late preterm deliveries appear consistent, though the reduction in absolute risk is smaller than in earlier gestations. Protocols should balance gestational age with potential long-term neurodevelopmental effects, which are underreported.
Conclusions: ACS reduces neonatal respiratory morbidity in late preterm births with acceptable short-term safety. Further research should focus on long-term outcomes and optimal dosing intervals.