Steroid shots given during pregnancy are a medical intervention used in specific situations. Many expectant parents have questions about their safety and purpose. These injections are a common tool in maternal and fetal medicine, aiming to improve outcomes for the baby when there is a possibility of preterm birth.
Why Steroid Shots Are Used
Steroid shots, also known as antenatal corticosteroids, are primarily administered to pregnant individuals at risk of delivering prematurely. Premature babies, especially those born before 35 weeks of gestation, often face health challenges because their organs, particularly their lungs, are not fully developed. These injections help to accelerate the maturation of the baby’s lungs.
The mechanism involves stimulating the production of surfactant, a complex mixture of lipids and proteins. Surfactant lines the tiny air sacs in the lungs, reducing surface tension and allowing the lungs to inflate properly after birth. Without sufficient surfactant, a premature baby can develop respiratory distress syndrome (RDS), a condition that makes breathing difficult and can lead to serious complications. By promoting surfactant production, corticosteroids help prepare the baby’s lungs for breathing outside the womb.
Safety for the Baby
The administration of a single course of antenatal corticosteroids is largely considered beneficial and safe for the unborn baby when used in appropriate circumstances. The well-established benefits include a significant reduction in the risk of respiratory distress syndrome, which is a major cause of illness and death in preterm infants. These shots also decrease the likelihood of other serious complications, such as bleeding in the brain (intraventricular hemorrhage) and severe bowel inflammation (necrotizing enterocolitis). Overall, a single course of steroids can improve survival rates and reduce the need for mechanical ventilation in preterm newborns.
While generally safe and beneficial, some temporary effects on the baby might be observed. For instance, there can be a brief reduction in fetal movements or changes in fetal heart rate variability for about 24 hours after the injection. These effects are usually transient and are not typically indicative of harm, with healthcare providers closely monitoring the baby following administration. Research continues to explore potential long-term outcomes, with current evidence suggesting no significant adverse effects on growth or neurodevelopment following a single course of corticosteroids given before 34 weeks of gestation.
Effects on the Pregnant Person
Steroid shots can lead to some short-term effects for the pregnant individual. A common temporary side effect is an increase in blood sugar levels, which typically resolves within a day or two. This effect is particularly important for individuals with pre-existing diabetes or gestational diabetes, who may require increased monitoring and adjustment of their insulin dosage during this time.
Other temporary effects can include facial flushing, soreness at the injection site, and difficulty sleeping. Some individuals might also experience minor mood changes. These effects are generally mild and do not typically last long. A single course of steroids is considered safe for the pregnant person and does not generally increase the risk of maternal infections.
Important Administration Guidelines
Antenatal corticosteroids are typically administered to pregnant individuals between 24 and 34 weeks of gestation who are at risk of preterm delivery within seven days. The decision to administer these injections is highly individualized and made by healthcare professionals based on the specific circumstances of the pregnancy.
A standard course usually involves two injections of betamethasone given 24 hours apart, or four injections of dexamethasone given 12 hours apart. These injections are given into a muscle, often in the thigh or upper arm. The benefits are most pronounced if delivery occurs between 24 hours and seven days after the first dose. Medical supervision is important throughout this process to ensure appropriate timing and monitoring.