{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,5]],"date-time":"2026-09-05T17:25:38Z","timestamp":1788629138677,"version":"build-2803163510"},"reference-count":42,"publisher":"Public Library of Science (PLoS)","issue":"3","license":[{"start":{"date-parts":[[2021,3,22]],"date-time":"2021-03-22T00:00:00Z","timestamp":1616371200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>Administration of antenatal corticosteroids (ANC) for impending preterm delivery beyond 34 weeks of gestation continues to be a controversial issue despite various guidelines for obstetricians and gynaecologists.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Objective<\/jats:title>\n<jats:p>To compare outcomes following exposure to ANC for infants born between 34\u201336<jats:sup>+6<\/jats:sup> weeks\u2019 gestation.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Methods<\/jats:title>\n<jats:p>A systematic review of randomised controlled trials (RCT) reporting neonatal outcomes after ANC exposure between 34\u201336+6 weeks\u2019 gestation using Cochrane methodology. Databases including PubMed, Embase, Emcare, Cochrane Central library and Google Scholar were searched in May 2020. Primary outcomes: (1) Need for respiratory support (Mechanical ventilation, CPAP, high flow) or oxygen (2) Hypoglycemia. Secondary outcomes included respiratory distress syndrome (RDS), transient tachypnoea of newborn (TTN), need for neonatal resuscitation at birth [only in the delivery room immediately after birth (not in neonatal intensive care unit (NICU)], admission to NICU, mortality and developmental follow up. Level of evidence (LOE) was summarised by GRADE guidelines.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Main results<\/jats:title>\n<jats:p>Seven RCTs (N = 4144) with low to high risk of bias were included. Only one RCT was from high income countries, Meta-analysis (random-effects model) showed (1) reduced need for respiratory support [5 RCTs (N = 3844); RR = 0.68 (0.47\u20130.98), p = 0.04; I<jats:sup>2<\/jats:sup> = 55%; LOE: Moderate] and (2) higher risk of neonatal hypoglycaemia [4 RCTs (N = 3604); RR = 1.61(1.38\u20131.87), p&lt;0.00001; I<jats:sup>2<\/jats:sup> = 0%; LOE: High] after ANC exposure. Neonates exposed to ANC had reduced need for resuscitation at birth. The incidence of RDS, TTN and surfactant therapy did not differ significantly. None of the included studies reported long-term developmental follow up.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec005\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Moderate quality evidence indicates that ANC exposure reduced need for respiratory support, and increased the risk of hypoglycaemia in late preterm neonates. Large definitive trials with adequate follow up for neurodevelopmental outcomes are required to assess benefits and risks of ANC in this population.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0248774","type":"journal-article","created":{"date-parts":[[2021,3,22]],"date-time":"2021-03-22T17:24:40Z","timestamp":1616433880000},"page":"e0248774","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":51,"title":["Antenatal corticosteroids for impending late preterm (34-36+6 weeks) deliveries\u2014A systematic review and meta-analysis of RCTs"],"prefix":"10.1371","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7485-4776","authenticated-orcid":true,"given":"Mangesh","family":"Deshmukh","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanjay","family":"Patole","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2021,3,22]]},"reference":[{"key":"pone.0248774.ref001","article-title":"Antenatal corticosteroids for accelerating fetal lung maturation for women at risk of preterm birth","volume":"3","author":"D Roberts","year":"2017","journal-title":"Cochrane Database Syst Rev"},{"issue":"2","key":"pone.0248774.ref002","doi-asserted-by":"crossref","first-page":"e102","DOI":"10.1097\/AOG.0000000000002237","article-title":"Committee Opinion No. 713: antenatal corticosteroid therapy for fetal maturation","volume":"130","author":"Practice CoO","year":"2017","journal-title":"Obstetrics and gynecology"},{"issue":"9","key":"pone.0248774.ref003","doi-asserted-by":"crossref","first-page":"1219","DOI":"10.1016\/j.jogc.2018.04.018","article-title":"No. 364-Antenatal corticosteroid therapy for improving neonatal outcomes","volume":"40","author":"A Skoll","year":"2018","journal-title":"Journal of Obstetrics and Gynaecology Canada"},{"issue":"1","key":"pone.0248774.ref004","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1016\/j.siny.2018.09.001","article-title":"Epidemiology of late preterm and early term births\u2014An international perspective","volume":"24","author":"M Delnord","year":"2019","journal-title":"Semin Fetal Neonatal Med"},{"issue":"3","key":"pone.0248774.ref005","doi-asserted-by":"crossref","DOI":"10.1542\/peds.2016-3331","article-title":"The \"Late Preterm\" Birth-Ten Years Later","volume":"139","author":"T Raju","year":"2017","journal-title":"Pediatrics"},{"issue":"6","key":"pone.0248774.ref006","doi-asserted-by":"crossref","first-page":"F479","DOI":"10.1136\/archdischild-2014-307347","article-title":"Neonatal outcomes and delivery of care for infants born late preterm or moderately preterm: a prospective population-based study","volume":"100","author":"EM Boyle","year":"2015","journal-title":"Archives of disease in childhood Fetal and neonatal edition"},{"issue":"2","key":"pone.0248774.ref007","doi-asserted-by":"crossref","first-page":"e223","DOI":"10.1542\/peds.2006-3629","article-title":"Effect of late-preterm birth and maternal medical conditions on newborn morbidity risk","volume":"121","author":"CK Shapiro-Mendoza","year":"2008","journal-title":"Pediatrics"},{"key":"pone.0248774.ref008","unstructured":"Barfield W LK. 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