of recommendationsCorticosteroids should be administered to women at a gestational age between 24+0 and 33+6 weeks, when preterm birth is anticipated in the next seven days, as these have been consistently shown to reduce neonatal mortality and morbidity. (Strong-quality evidence; strong recommendation). In selected cases, extension of this period up to 34+6 weeks may be considered (Expert opinion). Optimal benefits are found in infants delivered within 7 days of corticosteroid administration. Even a single-dose administration should be given to women with imminent preterm birth, as this is likely to improve neurodevelopmental outcome (Moderate-quality evidence; conditional recommendation).Either betamethasone (12 mg administered intramuscularly twice, 24-hours apart) or dexamethasone (6 mg administered intramuscularly in four doses, 12-hours apart, or 12 mg administered intramuscularly twice, 24-hours apart), may be used (Moderate-quality evidence; Strong recommendation). Administration of two "all" doses is named a "course of corticosteroids".Administration between 22+0 and 23+6 weeks should be considered when preterm birth is anticipated in the next seven days and active newborn life-support is indicated, taking into account parental wishes. Clear survival benefit has been observed in these cases, but the impact on short-term neurological and respiratory function, as well as long-term neurodevelopmental outcome is still unclear (Low/moderate-quality evidence; Weak recommendation).Administration between 34 + 0 and 34 + 6 weeks should only be offered to a few selected cases (Expert opinion). Administration between 35+0 and 36+6 weeks should be restricted to prospective randomized trials. Current evidence suggests that although corticosteroids reduce the incidence of transient tachypnea of the newborn, they do not affect the incidence of respiratory distress syndrome, and they increase neonatal hypoglycemia. Long-term safety data are lacking (Moderate quality evidence; Conditional recommendation).Administration in pregnancies beyond 37+0 weeks is not indicated, even for scheduled cesarean delivery, as current evidence does not suggest benefit and the long-term effects remain unknown (Low-quality evidence; Conditional recommendation).Administration should be given in twin pregnancies, with the same indication and doses as for singletons. However, existing evidence suggests that it should be reserved for pregnancies at high-risk of delivering within a 7-day interval (Low-quality evidence; Conditional recommendation). Maternal diabetes mellitus is not a contraindication to the use of antenatal corticosteroids (Moderate quality evidence; Strong recommendation).A single repeat course of corticosteroids can be considered in pregnancies at less than 34+0 weeks gestation, if the previous course was completed more than seven days earlier, and there is a renewed risk of imminent delivery (Low-quality evidence; Conditional recommendation).

1st department of Obstetrics and Gynecology Alexandra Hospital National and Kapodistrian University of Athens Athens Greece

Center for Perinatal and Reproductive Medicine University of Perugia Perugia Italy

Centre of Investigation in Environment Genetics and Oncobiology Coimbra Portugal

Chelsea and Westminster NHS Foundation Trust London UK

Coimbra Institute for Clinical and Biomedical Research Faculty of Medicine University of Coimbra Coimbra Portugal

Department of Clinical Sciences Pediatrics Umeå University Umeå Sweden

Department of General Pediatrics and Neonatology Justus Liebig University and Universities of Giessen and Marburg Lung Center Giessen Germany

Department of Genetics and Bioinformatics Domain of Health Data and Digitalization Institute of Public Health Oslo Norway

Department of Neonatology Gazi University Faculty of Medicine Ankara Turkey

Department of Obstetrics and Division of 'Experimental Obstetrics' Charité Universitätsmedizin Berlin Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin Berlin Germany

Department of Obstetrics and Gynaecology Maternity Koco Gliozheni Hospital Tirana Albania

Department of Obstetrics and Gynaecology University of Tartu Tartu Estonia

Department of Obstetrics and Gynecology 1 M Sechenov 1st State University of Moscow Moscow Russia

Department of Obstetrics and Gynecology Institute of Clinical Science Sahlgrenska Academy University of Gothenburg Gothenburg Sweden

Department of Obstetrics and Gynecology Region Västra Götaland Sahlgrenska University Hospital Gothenburg Sweden

Department of Obstetrics and Gynecology Robert Debré Hospital Assistance Publique Hôpitaux de Paris Paris France

Department of Obstetrics and Gynecology Semmelweis University Budapest Hungary

Department of Obstetrics and Gynecology University Hospital Hradec Kralove Charles University Faculty of Medicine in Hradec Králové Hradec Kralove Czech Republic

Department of Obstetrics Perinatology and Neonatology Center of Postgraduate Medical Education Warsaw Poland

Department of Perinatology Division of Obstetrics and Gynecology University Medical Centre Ljubljana Ljubljana Slovenia

Department of Women and Children's Health King's College London London UK

European Board and College of Obstetrics and Gynaecology Brussels Belgium

Faculty of Medicine

German Lung Research Center Giessen Germany

Institute of Biomedicine and Translational Medicine University of Tartu Tartu Estonia

Medical Faculty University of Ljubljana Ljubljana Slovenia

Medical School Santa Maria University Hospital Lisbon Portugal

Neonatal Intensive Care Unit 3rd Department of Pediatrics National and Kapodistrian University of Athens Athens Greece

Neonatal Medicine School of Public Health Faculty of Medicine Imperial College London London UK

Neonatology Clinic Department of Obstetrics and Gynecology Faculty of General Medicine Elias University Hospital Carol Davila University of Medicine and Pharmacy Bucharest Romania

Obstetrics Department Centro Hospitalar e Universitário de Coimbra Coimbra Portugal

PREIS International and European School of Perinatal Neonatal and Reproductive Medicine Florence Italy

Service de gynécologie obstétrique hôpital Robert Debré Université Paris Cité Paris France

Women's Clinic of Tartu University Hospital Tartu Estonia

References provided by Crossref.org