Antenatal Corticosteroids: Between Being a Useful Drug and Posing a Risk for Fetal and Adult Development

Antenatal corticosteroid therapy (ACST) is very important in reducing the sequelae of prematurity, respiratory distress syndrome (RDS), intraventricular hemorrhage (IVH), and necrotizing enterocolitis (NEC). This therapy has short-term and long-term neonatal consequences that range from reduced neonatal body weight, brain growth, hypertension, hypoglycemia and obesity to delayed neurological development. In addition to undeniable importance this type of therapy has on fetal maturation, it may also impact programming of fetuses future development and health during childhood and adulthood. ACST must be personalized, as a single course, and determined by indications and assessment of the expected time of delivery, so that the exposure time of the fetus to the effects of endogenous and exogenous steroids is shortened.