Antenatal Steroids in the Developing World: One Size Doesn't Fit All

Antenatal glucocorticoids to promote fetal lung maturity in pregnancies at risk for preterm delivery are one of the most dramatic success stories in perinatal medicine. The WHO estimated that hundreds of thousands of lives could be saved annually with appropriate use of antenatal steroids in low-resource settings. To test this hypothesis, investigators conducted a multinational trial of an intervention to increase antenatal steroid use among women suspected to be at risk for preterm delivery in low- and middle-income countries.

Nearly 100,000 women in Argentina, Zambia, Guatemala, and India were randomized to the intervention (a program to train providers in detecting preterm birth risk and administering corticosteroids in women in jeopardy)…