@article{33d6b669d3cf4f8cb03a40d13e668503,
title = "Antenatal corticosteroids for fetal maturation in women at risk for preterm delivery",
abstract = "The available data unambiguously support the beneficial, short-term fetal effects of antenatal corticosteroids in women at risk for preterm delivery. There are still several incompletely addressed questions, including the use of corticosteroids in women with preterm premature rupture of membranes, the optimal corticosteroid preparation to be used, and the impact of repeated dosing. These issues are discussed in this review from the perspective of recent scientific evidence on the mechanisms responsible for positive short-term effects on survival and possible harmful long-term effects.",
author = "Vidaeff, {Alex C.} and Doyle, {Nora M.} and Gilstrap, {Larry C.}",
note = "Funding Information: Until recently, there had been three other ongoing randomized studies, expected to be completed in 2004, comparing single and multiple courses of antenatal corticosteroids. The trial sponsored by the NIH Maternal Fetal Medicine Units Network, started in March 2000, was scheduled to include 2400 women. The Multiple Antenatal Corticosteroid Study (MACS), funded by the Canadian Health Research Institute and launched in 2001, is intended to report on 1900 American and Canadian women. Finally, the Trial of the Effects of Antenatal Multiple Courses of Steroids (TEAMS), organized by England's National Perinatal Epidemiology Unit, will enroll 4000 women [69] . Unfortunately, the trial sponsored by the NIH Maternal Fetal Medicine Units Network was prematurely stopped because of problems with enrollment. The other trials are still in progress at the time of this writing. The primary outcome measures of these studies are mainly reflective of short-term effects. There is now growing evidence from experimental studies that fetal exposure to excess corticosteroids at critical stages of development may have lifelong effects. Therefore, it is hoped that provisions have been made in all these studies for the long term follow-up of as many as possible exposed children. According to the Barker hypothesis of intrauterine programming, the reduced birthweight caused by corticosteroids may be a determinant of subsequent adult chronic morbidity. [70] The intrauterine exposure to increased levels of corticosteroids may also permanently program the fetus for elevated endogenous glucocorticoids levels, known risk factor for adult pathology and inappropriate reactivity to stressful stimuli [71] . ",
year = "2003",
month = dec,
doi = "10.1016/S0095-5108(03)00102-7",
language = "English (US)",
volume = "30",
pages = "825--840",
journal = "Clinics in Perinatology",
issn = "0095-5108",
publisher = "W.B. Saunders",
number = "4",
}