Adopting a consensus on the dose of antenatal steroids used by obstetric and neonatal services in Singapore in anticipation of imminent preterm birth.

Abstract

Abstract: In Singapore, glucocorticoids are administered to pregnant women at risk of imminent preterm delivery. The primary desired benefit is maturation of the preterm fetal lung. The commonly used antenatal steroid regimen in Singapore, two doses of 12 mg dexamethasone phosphate at a 12-h interval, is not widely used in other jurisdictions. There are important pharmacokinetic and pharmacodynamic differences between the glucocorticoids used to elicit fetal lung maturation. Acknowledging the range of society-endorsed clinical guidelines in worldwide use, we recommend that obstetric and neonatal services in Singapore work towards adopting a more widely accepted antenatal steroid dosing regimen: either two 11.4 mg maternal intramuscular injections of betamethasone (as betamethasone phosphate and betamethasone acetate), spaced by 24 h, or four 6 mg maternal intramuscular injections of dexamethasone phosphate spaced by 12 h.