Steroids at 34 weeks - Helpful or Harmful to preterm babies?

lololoco

It looks like I will have my baby around 34-35 weeks and since 24 weeks, my MFM doctor has said if/when the time comes and she's preterm, they will do the steroids to help mature her lungs. Everything I've been told and read said this was a good thing and wouldn't hurt.

Someone on another board is going to have her baby at 34w2d and the doctors are not giving her steroids because she said they said they do more harm than good. That's the first I've heard of that... from my doctors and my research.

Do you all have any info to support that? I'm just curious because I have heard no negatives to them. 

Thanks! 

E&RMommy

Current literature does not support steroids after 34 0/7.  At this gestational age, the lungs have the correct type of cells to produce surfactant.

There are still some docs who give steroids at 34 and later, but the general consensus is to stop at that point.

st.augbride

My docs did not give steroids after 34 weeks. Ds was born 34 weeks 5 days and I didn't have them. I trust them a lot since it's actually a huge research institute, so they are very on top of the latest research and thoughts on everything.

lololoco

Very interesting! I'm going to ask this week! Since I'm not to 34 weeks yet, NOT having them hasn't come up yet, but I was very surprised to hear that. Thanks for the info!

ijack

When I saw the post I actually posted on my private preemie board because I wasn't aware of any risks as well. What I learned is that there is proof that steroid shots can decrease head size (by a whopping 5%, so not a huge concern) and possibly lower IQ (by a couple points), which are the "down sides". However, in these studies the moms were given multiple (4-5) rounds of steroid shots, not the one that you would get.

After 32-34 weeks (depending on the study) there is a risk of pulmonary hypertension or pulmonary edema to the mother, especially when the steroids are mixed with a tocolytic, like terbutaline, and the benefit to the baby is minimal at this point.

So there isn't really a right or wrong answer. I was definitely surprised by what her docs told her because my experience is that most doctors take the "better safe than sorry" route with the shots and do them.