Safety of Antenatal Predniso(lo)ne and Dexamethasone on Fetal, Neonatal and Childhood Outcomes: A Systematic Review
Authors' conclusion
Based on the limited evidence found, predniso(lo)ne may have less side effects compared with dexamethasone in short- and long-term outcomes. Current literature shows minimal risk of side effects in the newborn from administration of a prenatal predniso(lo)ne dose of up to 10 mg per day.
Study context
- Population
- Human studies of long-term antenatal predniso(lo)ne or dexamethasone use, assessing side effects on the child in the fetal period, neonatal phase and childhood; PubMed/MEDLINE and Embase to August 202215 eligible studies + 7 from references
- Comparison
- Antenatal prednisone vs dexamethasone
- Outcome
- Side effects on the fetus, newborn and (pre)pubertal child
Methodological detailsSearch of PubMed/MEDLINE and Embase: 328 papers in PubMed and 193 in Embase identified; 15 eligible; 7 added through references
- Search of PubMed/MEDLINE and Embase: 328 papers in PubMed and 193 in Embase identified; 15 eligible; 7 added through references
Pooled result
As reported in the abstract
Side effects on fetal, neonatal and childhood outcomes
- Predniso(lo)ne may be associated with lower gestational age
- Predniso(lo)ne not associated with miscarriages and stillbirths, congenital abnormalities, differences in blood pressure or low blood glucose at birth
- Predniso(lo)ne not associated with low bone mass, long-term elevated cortisol and cortisone, or high blood pressure at prepubertal age
- Dexamethasone associated with miscarriages and stillbirths
- Dexamethasone associated, from age 16 years, with disturbed insulin secretion and higher glucose and cholesterol levels
- 15 eligible studies plus 7 records added through references
Original publication
Safety of Antenatal Predniso(lo)ne and Dexamethasone on Fetal, Neonatal and Childhood Outcomes: A Systematic Review. J Clin Endocrinol Metab. Published 16 September 2023. doi:10.
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