Effects of steroids as inducers of lung maturity in intrauterine growth restriction. A systematic review

Introduction: Intrauterine growth restriction (IUGR) is associated with perinatal morbidity and mortality. This includes increased foetal and neonatal morbidity and mortality, as well as prematurity. Glucocorticoids are given routinely to women between 24-34 weeks gestation at risk of preterm delivery. These are given to promote the production of surfactant. Although it has been postulated that the exogenous administration in IUGR may not provide any extra benefit, there is insufficient evidence to support its use in this sub-group of patients. Methods: In order to perform this systematic review, a search was made of the Medline, PubMed and Cochrane databases for relevant literature references. Those studies with a higher level of evidence that administered glucocorticoids (dexamethasone or betamethasone) to induce pulmonary maturation were selected and were compared with those using no treatment, during weeks 24-34 weeks gestation in pregnancies diagnosed with IUGR. Results: After assessment of the methodology, 6 items were used to create this review. Conclusions: Assessing the use of glucocorticoids in the pre-term foetus population with growth restriction remains controversial, with no randomised clinical studies in humans that allow us to make recommendations suitable for use.