Archives of Gynecology and Obstetrics

, Volume 288, Issue 6, pp 1223–1229

Retrospective analysis on the efficacy of corticosteroid prophylaxis prior to elective caesarean section to reduce neonatal respiratory complications at term of pregnancy: review of literature

  • Simone Paganelli
  • Emanuele Soncini
  • Giancarlo Gargano
  • Francesco Capodanno
  • Cristina Vezzani
  • Giovanni Battista La Sala
Review

DOI: 10.1007/s00404-013-3035-1

Cite this article as:
Paganelli, S., Soncini, E., Gargano, G. et al. Arch Gynecol Obstet (2013) 288: 1223. doi:10.1007/s00404-013-3035-1
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Abstract

Purpose

Our purpose was to conduct a systematic review of the literature to determine whether synthetic pharmaceutical glucocorticoids (betamethasone and dexamethasone) are safe as well as effective in reducing neonatal respiratory morbidity at term of pregnancy prior to elective caesarean section. The overall incidence of respiratory disorders is estimated at 2.8 %, and the main risk factors are gestational age and mode of delivery. Newborns delivered by elective caesarean section (CS after 37 weeks) are more susceptible to serious respiratory complications than babies born by vaginal delivery. Neonatal respiratory morbidity at term of pregnancy is low but not negligible. Further, it is increasing due to a drastic decline in trial of labour in those pregnant women who underwent a caesarean section in the past. Because prophylaxis is inexpensive, easy to administer, and safe, other studies should be conducted to confirm its effectiveness.

Methods

We conducted a systematic review of literature since 1965 on the discovery of action mechanisms, pharmaceutical development, proper dosage, and potential side effects of corticosteroids on the mother and offspring to extrapolate their efficacy as no clinical trial has directly demonstrated it.

Results

We extrapolated no negative effects on mother and foetus behaviour.

Conclusions

Human studies suggest that corticosteroid administration may become a proper clinical indication prior to caesarean section in the reduction of neonatal respiratory problems.

Keywords

Elective caesarean section Antenatal corticosteroids Transient tachypnea of the newborn (TTN) Respiratory distress syndrome of newborn (RDS) Dexamethasone Betamethasone 

Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • Simone Paganelli
    • 1
  • Emanuele Soncini
    • 1
  • Giancarlo Gargano
    • 2
  • Francesco Capodanno
    • 1
  • Cristina Vezzani
    • 1
  • Giovanni Battista La Sala
    • 1
  1. 1.Department of Obstetrics and Gynecology, Arcispedale S. Maria NuovaIstituto Tecnologie Avanzate e Modelli Assistenziali in Oncologia, IRCCSReggio EmiliaItaly
  2. 2.Neonatal Intensive Care Unit (NICU), Arcispedale S. Maria NuovaIstituto Tecnologie Avanzate e Modelli Assistenziali in Oncologia, IRCCSReggio EmiliaItaly

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