{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T23:04:07Z","timestamp":1780009447987,"version":"3.53.1"},"reference-count":23,"publisher":"Georg Thieme Verlag KG","issue":"08","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Perinatol"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>This study aimed to review the biologic mechanisms, clinical evidence, and therapeutic considerations surrounding antenatal corticosteroid (ACS) use in preterm pregnancies complicated by gestational and pregestational diabetes, with a particular focus on the late preterm period and associated neonatal outcomes.<\/jats:p>\n                  <jats:p>Narrative review of randomized trials, observational studies, and mechanistic investigations evaluating fetal lung development, ACS exposure, and neonatal respiratory outcomes in diabetic pregnancies.<\/jats:p>\n                  <jats:p>Diabetes disrupts fetal lung maturation through fetal hyperinsulinemia and delayed surfactant synthesis, resulting in increased neonatal respiratory morbidity extending into the late preterm period. While late preterm ACS reduce the need for neonatal respiratory support, including transient tachypnea of the newborn, in non-diabetic populations, pregestational diabetic pregnancies were excluded from pivotal trials. Emerging observational and randomized data suggest similar respiratory benefit in diabetic pregnancies, though accompanied by predictable metabolic effects, including maternal hyperglycemia, which are modifiable with anticipatory clinical management.<\/jats:p>\n                  <jats:p>Available biologic and clinical evidence supports consideration of late preterm ACS in pregnancies complicated by diabetes when delivery is anticipated within 7 days. With proactive metabolic management, respiratory benefits can be achieved while minimizing maternal and neonatal risks.<\/jats:p>","DOI":"10.1055\/a-2852-4997","type":"journal-article","created":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T22:52:24Z","timestamp":1777071144000},"page":"1098-1103","source":"Crossref","is-referenced-by-count":0,"title":["Antenatal Corticosteroids in Preterm Pregnancies Complicated by Diabetes: A Review and Clinical Commentary"],"prefix":"10.1055","volume":"43","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-4922-7113","authenticated-orcid":false,"given":"Arielle","family":"Higgs","sequence":"additional","affiliation":[{"name":"Division of Maternal Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, University of Maryland School of Medicine, Baltimore, Maryland, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kasey","family":"Meeks","sequence":"additional","affiliation":[{"name":"Division of Maternal Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, University of Maryland School of Medicine, Baltimore, Maryland, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E. Albert","family":"Reece","sequence":"additional","affiliation":[{"name":"Division of Maternal Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, University of Maryland School of Medicine, Baltimore, Maryland, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karl E.","family":"Seif","sequence":"additional","affiliation":[{"name":"Division of Maternal Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, University of Maryland School of Medicine, Baltimore, Maryland, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2026,4,24]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"617","DOI":"10.1146\/annurev.ph.46.030184.003153","article-title":"Fetal and postnatal development of the lung","volume":"46","author":"P H Burri","year":"1984","journal-title":"Annu Rev Physiol"},{"issue":"03","key":"ref2","doi-asserted-by":"crossref","first-page":"206","DOI":"10.1053\/sper.2002.33969","article-title":"Lung maturation in diabetes in pregnancy: if and when to test","volume":"26","author":"J M Piper","year":"2002","journal-title":"Semin Perinatol"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1146\/annurev.med.60.041807.123500","article-title":"Alveolar surfactant homeostasis and the pathogenesis of pulmonary disease","volume":"61","author":"J A Whitsett","year":"2010","journal-title":"Annu Rev Med"},{"issue":"09","key":"ref4","doi-asserted-by":"crossref","first-page":"2668","DOI":"10.1073\/pnas.69.9.2668","article-title":"Glucocorticoid receptors and the role of glucocorticoids in fetal lung development","volume":"69","author":"P L Ballard","year":"1972","journal-title":"Proc Natl Acad Sci U S A"},{"issue":"03","key":"ref5","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1203\/00006450-198503000-00001","article-title":"Fetal lung development in the diabetic pregnancy","volume":"19","author":"J R Bourbon","year":"1985","journal-title":"Pediatr Res"},{"issue":"07","key":"ref6","doi-asserted-by":"crossref","first-page":"357","DOI":"10.1056\/NEJM197602122940702","article-title":"Association between maternal diabetes and the respiratory-distress syndrome in the newborn","volume":"294","author":"M F Robert","year":"1976","journal-title":"N Engl J Med"},{"issue":"04","key":"ref7","doi-asserted-by":"crossref","first-page":"539","DOI":"10.1016\/0002-9378(73)90404-3","article-title":"Lecithin-sphingomyelin ratios in amniotic fluid in normal and abnormal pregnancy","volume":"115","author":"L Gluck","year":"1973","journal-title":"Am J Obstet Gynecol"},{"issue":"03","key":"ref8","first-page":"148","article-title":"Delayed appearance of pulmonary maturation markers is associated with poor glucose control in diabetic pregnancies","volume":"7","author":"J M Piper","year":"1998","journal-title":"J Matern Fetal Med"},{"issue":"07","key":"ref9","doi-asserted-by":"crossref","first-page":"719","DOI":"10.1016\/0002-9378(78)90233-8","article-title":"Amniotic fluid phosphatidylglycerol in diabetic pregnancies","volume":"131","author":"M D Cunningham","year":"1978","journal-title":"Am J Obstet Gynecol"},{"issue":"04","key":"ref10","doi-asserted-by":"crossref","first-page":"515","DOI":"10.1542\/peds.50.4.515","article-title":"A controlled trial of antepartum glucocorticoid treatment for prevention of the respiratory distress syndrome in premature infants","volume":"50","author":"G C Liggins","year":"1972","journal-title":"Pediatrics"},{"issue":"02","key":"ref11","first-page":"186","article-title":"Antenatal glucocorticoid therapy for the prevention of respiratory distress syndrome in the premature infant","volume":"50","author":"M F Block","year":"1977","journal-title":"Obstet Gynecol"},{"issue":"01","key":"ref12","doi-asserted-by":"crossref","first-page":"64","DOI":"10.1542\/peds.63.1.64","article-title":"Risk of respiratory distress syndrome after prenatal dexamethasone treatment","volume":"63","author":"H W Taeusch Jr","year":"1979","journal-title":"Pediatrics"},{"issue":"14","key":"ref13","doi-asserted-by":"crossref","first-page":"1311","DOI":"10.1056\/NEJMoa1516783","article-title":"Antenatal betamethasone for women at risk for late preterm delivery","volume":"374","author":"C Gyamfi-Bannerman","year":"2016","journal-title":"N Engl J Med"},{"issue":"19","key":"ref14","doi-asserted-by":"crossref","first-page":"1629","DOI":"10.1001\/jama.2024.4303","article-title":"Neurodevelopmental outcomes after late preterm antenatal corticosteroids: the ALPS follow-up study","volume":"331","author":"C Gyamfi-Bannerman","year":"2024","journal-title":"JAMA"},{"issue":"02","key":"ref15","doi-asserted-by":"crossref","first-page":"e102","DOI":"10.1097\/AOG.0000000000002237","article-title":"Antenatal corticosteroid therapy for fetal maturation. 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