Why Steroid Is Used In Pregnancy – Types And Side Effects

What you should know about steroids in pregnancy.

Pregnancy is a complex process that usually involves certain conditions before its success. The success of every pregnancy is the ability to carry your baby from “day one” to the due date (usually 9 months) in the absence of any health complications in both mother and baby. Contrary to this, there are some conditions that may arise which usually lead to going into premature labor – a situation where the body starts getting ready (having contractions, premature opening of the cervix, etc.) before the due date.

Pregnancy is unpredictable, the timeline of events from its first day to the due date is never known. This is why pregnant women should try as much as possible to understand their bodies, know when they need help, and never underestimate the importance of intense self-care.

What are steroids?

Steroids are chemicals that are made to act like hormones in humans. There are various types of steroids to serve different purposes, but we are interested in “steroids for pregnancy” which is a type of steroid called “Corticosteroids”.

Why are steroids used for pregnant women?

First of all, let’s talk about “preterm labor”. Undoubtedly, preterm labor results in having a preterm or premature baby. Preterm babies are usually given birth to before 37weeks. This makes a good number of them fragile and often have complicated medical problems.

Fetal oxygen is derived from their mother’s blood and it is usually transported to them by the placenta. After birth, the baby is “exposed” to a new environment that he/she has to adapt to for survival. One of the adaptations is by having well-developed lungs to inhale oxygenated air. Because it takes 37weeks to develop these lungs fully, preterm babies’ lungs are immature and this may result in difficulty in breathing.

So, this is why pregnant women need steroids to help speed up their baby’s lung development, especially to prevent lung problems in case of preterm birth.

How it works

Corticosteroids given to pregnant women are usually in the form of injections. You are right to call it a “lung maturity injection”. After injecting, the steroid travels through the placenta to the fetal bloodstream and finally to the lungs where it takes its actions. In the lungs, It stimulates pulmonary surfactant, a lipoprotein which allows the alveoli to remain opened and non-sticky (stickiness of the alveoli/air sac can make breathing difficult).

Types of steroids (corticosteroids) for pregnant women, their uses, dosage, and side effects

Betamethasone, Dexamethasone, and Prednisone are the common types of corticosteroids for pregnant women.

Betamethasone

Uses: Antenatal betamethasone is given to a woman having a preterm delivery. Betamethasone helps in lung development and breathing efficiency in preterm babies. It also lowers the risk of bleeding in the brain in babies.

Dosage: Betamethasone is usually given to pregnant women in the form of injection during preterm labor. A 12mg of betamethasone Injection is given 24 hours apart after the first dose. If the woman delivers before 24hours, the second dose will not be given.

Side effects: The normal dosage of betamethasone is 24mg given in two doses (12mg each) at 24 hours interval, most moms miss the second dosage because they deliver earlier. Not all, but some neonates whose moms miss the second dosage may develop respiratory distress syndrome (RDS)- a disorder that causes breathing difficulties.

2. Dexamethasone

Uses: DEX helps in lung development and reduces respiratory distress syndrome in neonates.

Dosage: The injection is given intramuscularly. 4 doses of 6mg are given 6 hours apart.

Side effects: Long term use of dexamethasone can reduce the weight of the baby. Incomplete dosage before delivery may also cause RDS in some babies.

3. Prednisone (Prednisolone)

Uses: It has anti-inflammatory properties and can be used by pregnant women for different conditions such as tuberculosis, asthma, heart conditions, skin conditions, arthritis, lupus, etc.

Dosage: They are taken orally and the dosage is according to the condition being treated.

Side effects: There may be a risk of low birth weight in babies and development of oral-facial cleft- a condition characterized by a cleft lip or cleft palate. Cleft lip and cleft palate are openings or split in the roof of the mouth, the upper lip to the nose, or both which is a result of the baby’s facial structure not forming completely. Prednisone if used for a long term can also cause premature birth.

The use of steroids during pregnancy is absolutely SAFE as long as it is used strictly by prescription. These corticosteroids have more benefits in pregnant women than risks. Doctor’s recommendation is important before taking any corticosteroids.