Antenatal corticosteroids in Singapore: a clinical and scientific assessment

Preterm birth (PTB; delivery prior to 37 weeks’ gestation) is the leading cause of early childhood death in Singapore today. Approximately 9% of Singaporean babies are born preterm; the PTB rate is likely to increase given the increased use of assisted reproduction technologies, changes in the incid...

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Bibliographic Details
Main Authors: Arundhati Gosavi, Zubair Amin, Sean William David Carter, Mahesh Arjandas Choolani, Erin Lesley Fee, Mark Amir Milad, Alan Hall Jobe, Matthew Warren Kemp
Format: Article
Language:English
Published: Wolters Kluwer – Medknow Publications 2024-09-01
Series:Singapore Medical Journal
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Online Access:https://journals.lww.com/10.4103/SINGAPOREMEDJ.SMJ-2022-014
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Summary:Preterm birth (PTB; delivery prior to 37 weeks’ gestation) is the leading cause of early childhood death in Singapore today. Approximately 9% of Singaporean babies are born preterm; the PTB rate is likely to increase given the increased use of assisted reproduction technologies, changes in the incidence of gestational diabetes/high body mass index and the ageing maternal population. Antenatal administration of dexamethasone phosphate is a key component of the obstetric management of Singaporean women who are at risk of imminent preterm labour. Dexamethasone improves preterm outcomes by crossing the placenta to functionally mature the fetal lung. The dexamethasone regimen used in Singapore today affords a very high maternofetal drug exposure over a brief period of time. Drawing on clinical and experimental data, we reviewed the pharmacokinetic profile and pharmacodynamic effects of dexamethasone treatment regimen in Singapore, with a view to creating a development pipeline for optimising this critically important antenatal therapy.
ISSN:0037-5675
2737-5935