Choice and dose of corticosteroid for antenatal treatments

Although antenatal glucocorticoids are standard of care for women at risk of preterm delivery before 32 to 34 weeks' gestation, the choice and dosing of the corticosteroid has not been standardized. An analysis of the trial data demonstrates that the risk of neonatal death is decreased with betamethasone, but not dexamethasone. Other clinical data also indicate that betamethasone is the drug of choice for antenatal treatment. The pharmacology of the corticosteroids suggests that a lower total glucocorticoid dose per treatment may be as effective as the current treatment recommendations. However, a change from current practice will require further randomized controlled trials. (C) 2004 Elsevier Inc. All rights reserved.