Antenatal corticosteroids for threatened labour facilitate thyroid maturation among preterm neonates

Abstract

Advances in perinatal care have improved the prognosis for preterm neonates. 1,2 Among them, the administration of antenatal corticosteroids (ANS) is one of the most effective. Since Liggins et al first reported that maternal ANS administration reduced the incidence of neonatal respiratory distress syndrome (RDS) in 1972, 3 its clinical efficacy has been verified in many studies. 4-6 The beneficial effects of ANS have been reported not only in reducing the incidence of RDS, but also in reducing the incidence of

Assessment of Thyroid Functions in Late Preterm Infants of Mothers on Antenatal Steroids

“…The current study showed that the mean TSH level was 4.36 and 4.24 in both complete and non-ANS courses, in line with our results, the study by Hanaoka et al (2020) showed that the TSH level was 6.2 and 7.6(mIU/L) respectively. They studied a group of 99 very low birth weight neonates (<34 weeks' gestational age) and divided into a complete group (n = 49) whose mothers completed two doses of betamethasone and a group with no ANS (n = 50) who were not exposed to any ANS.…”

“…On the contrary, Simonetta et al (2007) found that delivery room intubation and respiratory distress syndrome were more frequent in the ANS group and that the length of stay was also significantly longer in this group. Also, this comes in agreement with Hanaoka et al, (2020) who found that the ANS group needed less resuscitation and less servant administration.…”

“…The decrease in TSH by ANS might be considered as an unfavorable effect on the HPT axis, as glucocorticoids are known to have suppressive effects on this and can cause hypothyroidism, but in our study, the TSH level was in the normal range and the serum FT4 level was significantly different among the three studied groups, and we concluded that there was no evidence of suppression of FT4 by ANS, in acceptance with our results Hanaoka et al (2020) who found no difference in the serum FT4 level and TSH between the two groups( complete and non-ANS receiver), and no suppression of FT4 by ANS. Therefore, we consider that ANS therapy caused maturation of the HPT axis but not its suppression.…”

“…The incidence of hemodynamic instability and the consequent need for cardiac inotropic support could reflect the effect of steroids on the maturation of the preteen neonate and reflect the good function of the thyroid, so we evaluated the vital data of the neonates and subsequent need for inotropes and found that the complete ANS group needed less resuscitation (p0.02) and this comes in agreement of Hanaoka et al, (2020) who found that the ANS group needed less cardiac support although was statistically insignificant(p=0.39)…”

“…This comes in agreement of 11. Hanaoka et al, (2020) who found that the ANS group had higher APGAR scores at 1, 5 minutes.…”