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For a number of years, corticosteroids have been given to women at risk of delivering a preterm baby. The use of corticosteroids was, and is, thought to help reduce the risk of complications to the infant, associated with a preterm birth. The risks that corticosteroids guard against include the occurrence of respiratory distress syndrome, brain hemorrhages, patent ductus arteriosis, vascular abnormalities, and it reduces the chance of the infant dying as a result of the preterm birth.

In 1994, a panel convened by the National Institutes of Health (NIH) concluded that the use of corticosteroids was beneficial when a preterm birth was eminent. They were unsure, however, as to how much should be given and recommended further study as to what were the risks and benefits of giving women more than one course of antenatal corticosteroid treatments.

• In 2000, the National Institutes of Health reconvened the panel to review the data that has accumulated over the last six years, in part to discern if the use of corticosteroids was really warranted.
• At this meeting, they reaffirmed the effectiveness of using corticosteroids to reduce complications to preterm babies.
• They also stated that all women who are between the 24^th and 34^th week of pregnancy, and who are at risk of delivering prematurely within the next seven days, should be considered candidates for antenatal corticosteroid treatment.
• If the delivery is imminent, corticosteroid treatment may not be very effect, as full effectiveness of the treatment is not usually achieved for about 24 hours. As well, after seven days the treatment also losses its effectiveness.
• They did, however, recommend that only one course of corticosteroids be given to the mother, as multiple courses may represent a risk to the mother and the infant's health.
• When a single course is administered, there does not appear to be any adverse effects for either mother or child.
• However, in animal studies, repeated courses of corticosteroids have had negative side effects, such as impeding fetal lung development.

Corticosteroids are a class of drugs used to treat inflammatory illness. They are commonly used to treat diseases such as asthma and arthritis. Corticosteroids are similar to the hormone cortisone, which is produced naturally by the adrenal gland. Corticosteroids are totally different from the anabolic steroids used by muscle builders.

• When corticosteroids are prescribed for asthma suffers, the dosage is often administered via a nasal spray. In the minute amounts used for asthma treatments, there are few side effects.
• When a course of corticosteroids treatments are prescribed for preterm labor, the steroids are given intramuscularly at much higher dosage levels than for asthma treatment.

While the benefits of corticosteroids have been well documented, the risks associated with using corticosteroids for preterm birth, have not. Research is currently being conducted as to the risks of corticosteroids treatments, for both the mother and infant. In terms of a single corticosteroid treatment, the risks appear to be slight and they far outweigh the few side effects that the mother may suffer. However, when repeated courses are given the risks greatly increase, thereby diminishing the value of any potential beneficial effects.

• This is the basis for the NIH's recommendation that only one course of treatments be given, rather than repeated courses.

While all the data is not yet in, preliminary findings indicated that repeated treatments may place the mother at a risk of developing maternal infections and may impede the function of her endocrine system. For the infant, there appears to be an increased risk of neurological complications, decreased brain growth, long-term behavioral problems, an increase in lung diseases, and increased risk of death.