Objective
To examine the current literature surrounding the administration of antenatal corticosteroids in pregnancies complicated by diabetes and summarise the reported neonatal and maternal outcomes in exposed and unexposed groups.
Methods
A systematic search was performed using Ovid Medline and Embase databases to identify relevant studies. Maternal and neonatal outcomes of interest included neonatal respiratory distress syndrome, neonatal hypoglycaemia, and maternal hyperglycaemia. Key words in this search included combinations of the terms related to pre-gestational and gestational diabetes, antenatal corticosteroids, respiratory distress syndrome, hypoglycaemia, and hyperglycaemia. Title and abstract screening were conducted in duplicate.
Results
There were 19 studies that met the inclusion criteria. There were 13 studies that presented results pertaining to neonatal respiratory distress syndrome, 14 studies discussed neonatal hypoglycaemia, and five studies discussed maternal hyperglycaemia. This review found that there is no clear evidence of beneficial effect of corticosteroid administration on neonatal respiratory outcomes in pregnancies complicated by diabetes. Additionally, there was discrepancy between studies reporting on neonatal hypoglycaemia with six studies reporting an increased incidence in this outcome after antenatal corticosteroid exposure whilst four studies found no difference between exposed and unexposed groups. This review identified a specific gap in the reporting of maternal hyperglycaemia following antenatal corticosteroids. Most studies had small sample sizes and therefore lacked sufficient power to make robust conclusions about the influence of antenatal corticosteroids in this group.
Conclusion
This scoping review concludes that there are insufficient data regarding the risks and benefits of antenatal corticosteroid administration in pregnancies complicated by diabetes.