Steroid injection in pregnancy side effects for mom

This information is for you if you are pregnant and have been recommended to have a course of corticosteroids because there is a possibility that you may have your baby early.

It may also be helpful if you are a partner, relative or friend of someone in this situation or if you are interested in knowing about corticosteroids in pregnancy.

Please note: this information is currently being updated to align with the recently updated Green-top Guideline Antenatal corticosteroids to reduce neonatal morbidity and mortality.’

The information here aims to help you better understand your health and your options for treatment and care. Your healthcare team is there to support you in making decisions that are right for you. They can help by discussing your situation with you and answering your questions.

This information covers:

• What corticosteroids are
• Why corticosteroids are helpful in pregnancy
• Whether corticosteroids can harm you and your baby
• When in pregnancy corticosteroids should be given, and to whom

You can see a full glossary of all medical terms.

Corticosteroids are a type of medication given to you to help your baby if there is a possibility that you may have your baby early. Corticosteroids are given by an injection into the muscle usually of your thigh or upper arm. A single course can consist of two to four injections usually over a 24–48-hour period.

Corticosteroids have been used for many years in women who are thought to have a high chance of having their baby early. Premature babies (born before 37 weeks) have an increased risk of health problems, particularly with breathing, feeding and infection. These problems tend to be more severe the earlier the baby is born.

A single course of corticosteroids has been shown to help with a baby’s development and therefore will increase the chance of your baby surviving, once born. It also lessens the chance of your baby having serious complications after birth such as breathing problems owing to the lungs not being fully developed, bleeding into the brain, serious infection or bowel inflammation.

A single course of two to four injections is considered to be safe for you and your baby. More evidence is needed to say whether two or more courses of corticosteroids during pregnancy are safe for your baby.

Corticosteroids help most if they are given to you between 24 weeks and 34 weeks plus 6 days of pregnancy. If you are having a planned caesarean section between 35 and 38 weeks plus 6 days, corticosteroids are usually recommended. Corticosteroids may be given earlier than 24 weeks, but the evidence that they will be helpful for your baby in that situation is less clear; a senior doctor will discuss this with you.

Corticosteroids are of most help if the last dose is given to you between 24 hours and 1 week before you have your baby. There may still be benefit even if your baby is born within 24 hours of the first dose.

You may be advised to have corticosteroids if there is an increased chance that your baby will be born before 35 weeks of pregnancy. This includes:

• if you are in premature labour
• if you are suspected to be in premature labour but this has not been confirmed yet
• if your waters break even if you are not having contractions
• if it may benefit your baby to be delivered early, for example if your baby is not growing
• if it may benefit you to have your baby early, for example if you are seriously unwell, are bleeding heavily or have severe pre-eclampsia (see RCOG Patient Information: Pre-eclampsia).

If you are having a planned caesarean section before 39 weeks of pregnancy, corticosteroids are recommended to lessen the chance of breathing problems for your baby.

If you have diabetes or gestational diabetes, you may need to be in hospital since corticosteroids increase the blood sugar level.

Giving treatment just in case an event occurs is known as prophylactic treatment. If you have previously had a baby born early, have a multiple pregnancy or have had treatment to your cervix (entrance to the womb), prophylactic treatment with corticosteroids early in pregnancy is not recommended because there is no evidence that it will help your baby.

Corticosteroids can suppress the mother’s immune system, but there is no evidence that a single course of corticosteroids will cause harm even if you have a severe infection. If you or your baby are unwell, corticosteroids will usually be started but delivery of your baby will not be delayed to allow you to complete the course.

If you have had one course of corticosteroids, you are unlikely to be recommended further courses later in the same pregnancy.

Sources and acknowledgements

This information has been developed by the RCOG Patient Information Committee. It is based on the RCOG guideline Antenatal corticosteroids to reduce neonatal morbidity (October 2010). The guideline contains a full list of the sources of evidence we have used.

This information has been reviewed before publication by women attending clinics in Camberley, Liverpool and Great Yarmouth.

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