Choice of Antenatal Steroids for Prevention of Complications of Prematurity: Betamethasone Versus Dexamethasone

Abstract

Antenatal steroids (ANS) are proven strategies to maximize outcomes of premature neonates without any major maternal side effects. Their use results in decreased incidence of neonatal mortality and major morbidities (respiratory distress syndrome, early onset sepsis, necrotizing enterocolitis, and intraventricular hemorrhage). However, due to concerns of long-term adverse effect (early onset hypertension and poor neurological outcome), a close follow-up is required. Similarly, due to lack of long-term follow-up data and potential risk of hypoglycemia, a cautious use is recommended in late preterms and elective cesareans. There is currently no consensus regarding preferential use of one ANS over the other. The current review therefore tried to address these issues for use of ANS in Indian prospective in light of recent emerging evidence. Due to better safety profile, lesser side effects, lower cost, and easy storage, we recommend dexamethasone as a steroid of choice for antenatal prophylaxis.