Peer-reviewed article
Neonatal outcomes following antenatal corticosteroid administration before planned caesarean birth at late preterm or early term (36-38 weeks' gestation): a retrospective cohort study.
Kassie GM, Frier E, Poprzeczny AJ, Stark M, Grzeskowiak L ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study examined whether giving corticosteroids to pregnant women before planned caesarean delivery between 36 and 38 weeks helps newborn health. The treatment reduced respiratory distress in newborns across all gestational ages, with the strongest benefit at 36 weeks. However, when birth occurred after 37 weeks, the treatment was associated with increased risk of low blood sugar, admission to neonatal care, and longer stays in neonatal units.
Key points
- Antenatal corticosteroids reduced respiratory distress requiring oxygen, with greatest reduction at 36 weeks (12.5% reduction)
- At 38 weeks' gestation, corticosteroid administration increased neonatal hypoglycaemia risk by 5.7%
- At 38 weeks' gestation, corticosteroid administration increased neonatal unit admission risk by 5.4%
- 54.8% of women at 36 weeks received corticosteroids, decreasing to 5.6% at 38 weeks
- Overall net benefit of corticosteroids before planned caesarean birth remains unclear
Limitations
This is an observational study using retrospective data from one region of Australia, so causation cannot be definitively established and results may not generalise to other populations or healthcare settings. The study does not explain the mechanisms behind increased harms at later gestations.
Abstract
Objective To investigate the benefits and harms associated with antenatal corticosteroids (ACS) prior to planned caesarean birth at late preterm or early term. Design Retrospective cohort study. Setting South Australia, Australia, 2005-2018. Patients Women with singleton pregnancies undergoing planned caesarean birth between 36+0 and 38+6 weeks' gestation. Methods We used routinely collected electronic maternity and neonatal data. Adjusted risk differences (aRD) with 95% CIs were calculated for neonatal and maternal outcomes. Outcome measures Neonatal outcomes included respiratory distress requiring oxygen, hypoglycaemia requiring glucose, neonatal unit (NNU) admission and prolonged NNU admission (≥48 hours). Results Among the cohort of 4049 women, the proportion receiving ACS was 54.8%, 48.4% and 5.6% at 36, 37 and 38 completed weeks' gestation, respectively. ACS administration was associated with a significant reduction in respiratory distress across all gestations, with the greatest reduction seen at 36 weeks' gestation (aRD -12.5%; 95% CI -21.4% to -3.6%). At 38 weeks' gestation, ACS administration was associated with an increased risk of neonatal hypoglycaemia (aRD 5.7%; 95% CI 1.1% to 10.2%), NNU admission (aRD 5.4%; 95% CI 0.1% to 10.7%) and prolonged NNU admission (aRD 4.6%; 95% CI 0.2% to 8.9%). Conclusions ACS administration prior to late preterm and early term planned caesarean birth was associated with reduced risk of respiratory distress. The net benefit of ACS administration before planned caesarean birth remains unclear; however, there was evidence of potential neonatal harm when birth occurred after 37 weeks' gestation.
Findings the Hub has extracted
Each claim below is labelled by its type of design and links back to this report.
- Intervention
- Antenatal corticosteroid administration prior to planned caesarean birth
- Population
- Women with singleton pregnancies undergoing planned caesarean birth between 36+0 and 38+6 weeks' gestation in South Australia
Key finding
At 36 weeks: respiratory distress reduction of 12.5% (95% CI -21.4% to -3.6%)
GM et al. · Europe PMC · 1 Sept 2026