Antenatal steroids at 34 to 37 weeks of preterm birth
For pregnant women who will deliver at 340/7th to 366/7th weeks of gestation (late preterm) by scheduled cesarean, one should administer the first course of antenatal corticosteroids.
Antenatal corticosteroids given at 23 to 34 weeks of gestation to women at risk for preterm delivery reduce the incidence and severity of respiratory distress syndrome in offspring delivered of administration. Steroids have not been administered after 34 weeks.
Recently, the Antenatal Late Preterm Steroids (ALPS) Trial randomly assigned women at 340/7th to 365/7th weeks of gestation at high risk for late preterm birth to receive a first course of antenatal betamethasone or placebo and found that the frequency of a composite outcome of neonatal respiratory problems was reduced in the betamethasone group.
Do not administer steroids in women who have received a course of antenatal corticosteroids earlier in pregnancy or in whom delivery at 340/7th to 366/7th weeks is uncertain.
Also, avoid steroids in women attempting vaginal delivery.