Steroids prescribed in pregnancy

This information is for you if you have been recommended to have a type of steroid medication (corticosteroids) given to you to help your baby if there is a possibility that you may deliver your baby early.

Corticosteroids are given by an injection into the muscle of your thigh or upper arm. At the RVI we give two doses each by injection 24 hours apart.

When are corticosteroids not necessary?Show [+]Hide [-]

Giving treatment just in case an event occurs is known as prophylactic treatment. If you have previously had a baby born early, have a multiple pregnancy or have had treatment to your cervix (entrance to the womb), prophylactic treatment with corticosteroids early in pregnancy is not recommended because there is no evidence that it will help your baby.

Are there circumstances where corticosteroids are not advised?

If you or your baby are unwell, corticosteroids will usually be started but delivery of your baby will not be delayed to allow you to complete the course. Corticosteroids can suppress the mother’s immune system, but there is no evidence that a single course of corticosteroids will cause harm even if you have a severe infection.

Can I have more than one course of corticosteroids in this pregnancy?

If you have had one course of corticosteroids, you are unlikely to be recommended further courses later in

Can corticosteroids harm me or my baby?Show [+]Hide [-]

A single course is considered to be safe for you and your baby. More evidence is needed to say whether two or more courses of corticosteroids during pregnancy are safe for your baby.

Corticosteroids help most if they are given to you between 24 weeks and 34 weeks plus six days of pregnancy. If you are having a caesarean section between 35 and 38 weeks plus six days, corticosteroids are usually recommended. They may be given earlier than 24 weeks, but the evidence that they will be helpful for your baby in that situation is less clear; a senior doctor will discuss this with you.

Corticosteroids are of most help if the last dose is given to you between 24 hours and one week before you have your baby. There may still be benefit even if your baby is born within 24 hours of the first dose. If you have diabetes or gestational diabetes, you may need to be in hospital for two or three days monitoring since corticosteroids increase the blood sugar level.

We offer corticosteroids if there is an increased chance that your baby will be born before 35 weeks of pregnancy.

For example:

  • if you are in premature labour
  • if you are suspected to be in premature labour but this has not been confirmed yet
  • if your waters break even if you are not having contractions
  • if it may benefit your baby to be delivered early, for example if your baby is not growing
  • if it may benefit you to have your baby early, for example if you are seriously unwell, are bleeding heavily or have severe preeclampsia
  • If you are having a planned caesarean section before 39 weeks of pregnancy, corticosteroids are recommended to lessen the chance of breathing problems for your baby.

Why are corticosteroids helpful?Show [+]Hide [-]

Corticosteroids have been used for many years in women who are thought to have a high chance of having their baby early (before 34 weeks).

Although all premature babies (born before 37 weeks) have an increased risk of health problems, particularly with breathing, feeding and infection, these problems tend to be more severe the earlier the baby is born.

A single course of corticosteroids has been shown to help with a baby’s development and therefore will increase the chance of your baby surviving, once born. It also lessens the chance of your baby having serious complications after birth such as breathing problems owing to the lungs not being fully developed, bleeding into the brain, serious infection or bowel inflammation.

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