Question 61

Neonatal hypoglycaemia is an important recognised consequence of recent antenatal corticosteroid exposure in the late-preterm period. This risk is particularly important when corticosteroids are considered between 35+0 and 36+6 weeks, where the respiratory benefit must be balanced against an increased frequency of neonatal hypoglycaemia. In the major late-preterm trial, hypoglycaemia occurred in 24.0% of corticosteroid-exposed neonates compared with 15.0% after placebo, corresponding to an approximate number needed to harm of 11. This does not mean that corticosteroids should never be used late preterm, but it reinforces the need for appropriate counselling before treatment and standard neonatal assessment and management after birth. The listed alternatives are not the characteristic adverse neonatal effect emphasised in this context. Therefore, after recent late-preterm exposure, neonatal glucose assessment is particularly relevant as part of routine postnatal care.

B) Hypercalcaemia is not the characteristic neonatal adverse effect highlighted after late-preterm corticosteroid exposure.

C) Persistent neonatal hypertension is not the principal recognised adverse effect in this setting.

D) Corticosteroid-induced neonatal polycythaemia is not the relevant adverse effect.

E) Congenital hypothyroidism is not a recognised consequence of late-preterm antenatal corticosteroid exposure in this context.

F) Neonatal hypermagnesaemia is not the relevant corticosteroid-associated complication.

G) Severe neonatal thrombocytosis is not the characteristic adverse effect described.

H) Neonatal hypernatraemia is not the principal complication associated with late-preterm antenatal corticosteroids.

Stock SJ, Thomson AJ, Papworth S, on behalf of the Royal College of Obstetricians and Gynaecologists. Antenatal corticosteroids to reduce neonatal morbidity and mortality. BJOG. 2022;129:e35–e60. RCOG Green-top Guideline No. 74. doi:10.1111/1471-0528.17027.