The use of antenatal dexamethasone to mature the fetal lung in pregnancies
likely to deliver before 34 weeks is almost universal, It reduces the incid
ence of respiratory distress syndrome in the newborn and results in an over
all improvement in neonatal morbidity and mortality. Although considered to
be generally safe, there are concerns about adverse maternal and fetal eff
ects. In a series of studies, we have found that antenatal dexamethasone ad
ministration is associated with reduced placental hormone production and ma
ternal bone formation, impaired glucose tolerance and altered function of t
he hypothalamic-pituitary-adrenal axis. In this article, we have compared o
ur data with other reports in the human and reviewed the relevant animal da
ta. We conclude that further studies on the long-term effects of antenatal
dexamethasone therapy in the human are warranted with particular emphasis o
n the long-term effects on the fetus.