Maternity
Who is this information for?
This information is for you if you are pregnant and have been advised by your doctor or midwife to have steroid injections because there is a possibility that you may have your baby early.
It is also useful if you are having a planned caesarean before 39 weeks.
What are Steroids?
Corticosteroids are a man-made version of a chemical produced by the body. It may be offered to you to help your baby if there is a chance that you may give birth early.
Steroids are given by an injection into the muscle usually of your thigh or upper arm.
At Russells Hall Hospital dexamethasone is the drug used and it is given as two injections 24 hours apart – this is known as a course of steroids.
Who should be given steroids?
You may be advised to have steroids if there is an increased chance that your baby will be born before 35 weeks of pregnancy.
This includes:
If you are having a planned caesarean section before 39 weeks of pregnancy, steroids may be sometimes recommended to lessen the chance of breathing problems for your baby.
If you are between 22 – 24 weeks and at risk of labour, your doctor will discuss the benefits of steroids with you on an individual basis.
What are the benefits of Steroids?
Steroids reduce the risk of Respiratory Distress Syndrome (RDS), bleeding on the brain, serious infections and bowel inflammation.
They may benefit babies born extremely preterm the most.
A single course of steroids increases the chances of survival.
Steroids less than 34 weeks reduce the risk of:
NEC – Necrotising Enterocolitis: A serious condition characterised by the inflammation and death of intestinal tissue
IVH – Intraventricular Haemorrhage: Bleeding on the brain
Steroids have the best effect if given between 24 hours and one weeks of birth but there is still some benefit if birth occurs <24 hours after being given.
Can steroids harm my baby?
A single course of two to four injections is considered to be safe for you and your baby.
Steroids can cause some side effects such as:
There is evidence that babies exposed to steroids in the womb have a lower birthweight and are more prone to low sugars after birth.
One study suggests that if you are given steroids before a planned caesarean birth after 37 weeks of pregnancy there is a possible link between this and your child not doing as well at school when they are older, but more research is needed.
Can I have more than one course of steroids in pregnancy?
If you have had a course of steroids and you do not give birth in the next 7 days, then a second course might have some beneficial effects on your baby’s breathing if they are still expected to be born prematurely.
Evidence to support this benefit is limited and there is also evidence that a repeat course of steroids may mean your baby is smaller than they should be when they are born.
Your healthcare professional will advise you of the risks and benefits of a repeat course of steroids depending on your individual situation.
What if I have Diabetes/Gestational diabetes?
If you have diabetes or gestational diabetes and are advised to receive steroid injections during pregnancy, it’s important to understand how this treatment may affect your blood sugar levels and the necessary steps to manage them effectively.
While beneficial for your baby’s development, corticosteroids can cause a temporary increase in your blood sugar levels. This effect is particularly significant if you have pre-existing diabetes or gestational diabetes. Elevated blood sugar levels may persist for several days after the steroid administration.
Due to the anticipated rise in blood sugar levels, you may need to be admitted to the hospital for 2–3 days to monitor and manage your glucose levels effectively. During this period, healthcare professionals will regularly check your blood sugar and may adjust your diabetes medication or administer insulin to maintain optimal control. This proactive approach helps prevent potential complications for both you and your baby.
Are there any circumstances where I wouldn’t be able to have steroids?
Corticosteroids can suppress the mother’s immune system, but a single course of steroids is likely to be beneficial for baby even if you have a severe infection.
If you or your baby are unwell, steroids will usually be started but the birth of your baby will not be delayed to allow you to complete the course.
If you have any questions, or if there is anything you do not understand, please contact the Russells Hall Hospital switchboard number on (01384) 456111 and ask for the relevant department who issued this leaflet.
This leaflet can be made available in large print, audio version and in other languages, please call 0800 073 0510.
Originator: Aqeela Hamilton Date Originated: March 2025. Review Date: March 2028