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Antenatal Corticosteroids—Too Much of a Good Thing?
Edward E. Lawson, MD
JAMA. 2001;286:1628-1630.
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Changes in management regarding care of neonates resemble the swings of a pendulum. As the force of gravity keeps a pendulum from swinging too far, continuing medical research keeps management from becoming too extreme. Research permits evaluation of the risks and benefits of a particular treatment, advancing knowledge to refine the risk-benefit ratio and alter clinical care. Unfortunately, despite apparently proper research protocols, physicians do not always correctly understand risks and benefits regarding any specific issue. Therefore, occasionally the recommended management may become transiently out of phase with the ultimate "best practice."
For years, physicians have known that antenatal betamethasone or dexamethasone, when administered at least 24 hours before delivery, reduces the incidence of respiratory distress syndrome (RDS) in neonates between 24 and 32 weeks' gestation. Consensus on this point swung through phases as early studies supported the use of antenatal corticosteroids,1-3 then a major National . . . [Full Text of this Article]
Author Affiliation: Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, Md.
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