Potential risks and benefits of antenatal corticosteroid therapy prior to preterm birth in pregnancies complicated by severe fetal growth restriction.

The antepartum administration of fluorinated corticosteroids for fetal maturation represents the most important clinical contribution in the battle against prematurity. This treatment reduces the risk of neonatal death and handicap. It is also known that on corticosteroid exposure, fetuses are subjected to transiently increased physiologic and metabolic demands. Healthy fetuses are able to cope, although emerging evidence suggests this may not be the case with severely growth-restricted fetuses. This review presents evidence of efficacy and safety pertaining to corticosteroid administration in fetal growth restriction–affected pregnancies, offers guidance to clinicians, and points out questions that still need answers.