Multiple courses of corticosteroids

A Cochrane systematic review of RCTs of women receiving a re­peated dose of corticosteroids for risk of PTB at least 7 days after their initial dose (4730 women, 5650 babies) showed a reduced risk of infants having RDS and a reduction in a composite of serious in­fant outcomes. However, treatment with repeat doses was also as­sociated with a reduction in mean birth weight (mean difference -75.79 g; 95% CI -117.63 to -33.96 g) (78). With no definitive evi­dence for multiple courses, Cochrane data supports the continued use of only a single course of antenatal corticosteroids to accelerate fetal lung maturation in women at risk of preterm birth (77).