ReviewPediatric research2021
Antenatal corticosteroids: a reappraisal of the drug formulation and dose.
Review in Pediatric research, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 34 papers, 5 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
34 citing papers in PubMed, 5 syntheses or guidelines pooled it, 62 citations in OpenAlex.
- A systematic review of glucocorticoid use in type 1 diabetes: Glycaemic effects and clinical management strategies.Diabetes, obesity & metabolism · 2026Pooled it
- The proportions of term or late preterm births after exposure to early antenatal corticosteroids, and outcomes: systematic review and meta-analysis of 1.6 million infants.BMJ (Clinical research ed.) · 2023Pooled it
- European Consensus Guidelines on the Management of Respiratory Distress Syndrome: 2022 Update.Neonatology · 2023Guideline
- Different corticosteroids and regimens for accelerating fetal lung maturation for babies at risk of preterm birth.The Cochrane database of systematic reviews · 2022Pooled it
- Evaluation of Long-term Outcomes Associated With Preterm Exposure to Antenatal Corticosteroids: A Systematic Review and Meta-analysis.JAMA pediatrics · 2022Pooled it
- Glucocorticoids in pregnancy: a master-switch for fetal maturation.Endocrine reviews · 2026Review
- Article
- Glucocorticoid Signaling in PSC-Derived Neural Systems to Elucidate Mechanisms of Stress-Induced Psychiatric Vulnerability.Molecular neurobiology · 2026Review
- Systemic glucocorticoid activity in extremely preterm neonates after antenatal betamethasone and intratracheal budesonide: a sub-study of the PLUSS trial.Journal of perinatology : official journal of the California Perinatal Association · 2026Article
- Postnatal Steroids in Preterm Infants: A Narrative Review Series-Part 1: Inflammatory Modulation and Respiratory Impacts.Children (Basel, Switzerland) · 2026Review
- Dexamethasone dosage and course effects on respiratory outcomes in preterm twins: retrospective cohort study.Scientific reports · 2025Article
- Pharmacokinetics of betamethasone in pre-eclampsia: An in vivo and ex vivo study.British journal of clinical pharmacology · 2025Article
- Respiratory distress syndrome is the poster child for neonatology.Pediatric research · 2025Article
- Insulin-Like Growth Factor 2 Reverses Synaptic and Cognitive Deficits in Fetal Growth Restriction Mice.FASEB journal : official publication of the Federation of American Societies for Experimental Biology · 2025Article
- Article
- Single-nucleotide polymorphisms in dizygotic twin ovine fetuses are associated with discordant responses to antenatal steroid therapy.BMC medicine · 2025Article
- Perinatal glucocorticoid sensitivity in the preterm newborn: molecular mechanisms, endogenous determinants, and clinical implications.Frontiers in endocrinology · 2025Review
- Antenatal corticosteroids in Singapore: a clinical and scientific assessment.Singapore medical journal · 2024Review
- Antenatal steroids elicited neurodegenerative-associated transcriptional changes in the hippocampus of preterm fetal sheep independent of lung maturation.BMC medicine · 2024Article
- Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 3 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
We review the history of antenatal corticosteroid therapy (ACS) and present recent experimental data to demonstrate that this, one of the pillars of perinatal care, has been inadequately evaluated to minimize fetal exposure to these powerful medications. There have been concerns since 1972 that fetal exposures to ACS convey risk. However, this developmental modulator, with its multiple widespread biologic effects, has not been evaluated for drug choice, dose, or duration of treatment, despite over 30 randomized trials. The treatment used in the United States is two intramuscular doses of a mixture of 6 mg betamethasone phosphate (Beta P) and 6 mg betamethasone acetate (Beta Ac). To optimize outcomes with ACS, the goal should be to minimize fetal drug exposure. We have determined that the minimum exposure needed for fetal lung maturation in sheep, monkeys, and humans (based on published cord blood corticosteroid concentrations) is about 1 ng/ml for a 48-h continuous exposure, far lower than the concentration reached by the current dosing. Because the slowly released Beta Ac results in prolonged fetal exposure, a drug containing Beta Ac is not ideal for ACS use. IMPACT: Using sheep and monkey models, we have defined the minimum corticosteroid exposure for a fetal lung maturation. These results should generate new clinical trials of antenatal corticosteroids (ACS) at much lower fetal exposures to ACS, possibly given orally, with fewer risks for the fetus.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.