Steroids for preterm labor

The National Institutes of Health (NIH) and the American Congress of Obstetricians and Gynecologists (ACOG) recommends steroids during labor if  your  pregnancy is between 24 and  34 weeks. Before 24 weeks , the fetus may be too immature to benefit from the steroid . After 34 weeks, the baby’s lungs will be sufficiently developed . However steroids may still be given if fetal lung test suggests its still immature. Betamethasone is the most commonly used steroid.

Timing the dose of steroids is very important. It must be given to the woman as an injections several hours before the baby is delivered.  A second dose is usually given 24 hours after the first dose. The greatest benefit of steroid is when given at least 48 hours before the baby is delivered. There is probably some benefit even if the woman doesn’t receive the second dose. It is usually not necessary to repeat the steroid treatment if preterm labor recurs.

Steroids  speed up the lungs of premature babies . It helps the lungs to mature and may promote the production of surfactants.  Surfactants is a substance that prevents the collapse of the alveoli (small sacs in the lungs where air is exchanged). Babies whose mother receive this treatment are much less likely to suffer respiratory distress syndrome and bleeding in the brain.

This treatment is also known to reduce the premature baby’s risk of a potentially life threatening intestinal disease known as necrotizing enterocolitis.

Although rare, steroids can increase your blood sugar to levels that will require you to take insulin. If you have gestational diabetes , you may need to increase the dosage of your insulin .

Another uncommon complication that may occur when if you’re taking steroids with tocolytics ( medication to stop preterm labor) is pulmonary edema. This condition is a buildup of fluid in the lungs. If you are taking both medications, you will be monitored carefully even though the risk for pulmonary edema is low.

However steroids are safe for moms in the long term. The benefit of using this medication outweighs the risks.