ABSTRACT
Objective: The administration of corticosteroids, whether as a single or repeated dose, remains controversial due to its implications for reducing side effects in neonates and its impact on maternal morbidity and mortality. Material and Methods: We searched PubMed, ScienceDirect, WileyOnline, CENTRAL, and ClinicalTrials.gov for randomized controlled trials published between January 2000- March 2024. The studies assessed the neonatal and maternal outcomes of repeated corticosteroid administration (24 mg betamethasone or dexamethasone as rescue or weekly dose) after an initial 24 mg course in preterm pregnancies. A random effects model was used for statistical analysis. Results: A meta-analysis of 13 trials involving 5,246 pregnant women and 5,960 neonates found that repeated corticosteroid administration significantly reduced the risks of respiratory distress syndrome [relative risk (RR) 0.96, 95% confidence interval (CI) 0.78-0.95], oxygen supplementation (RR 0.93, 95% CI 0.87-0.99), mechanical ventilation (RR 0.80, 95% CI 0.72-0.89), and surfactant use (RR 0.76, 95% CI 0.68-0.86). However, it was associated with lower birth weights [mean birth weight (MD)-85.67 g, 95% CI -141.94 to -29.41] and increased maternal chorioamnionitis (RR 1.26, 95% CI 1.03-1.54). No significant differences were observed for maternal endometritis, hypertensive complications, adverse events, or latency intervals. Conclusion: Repeated corticosteroid administration reduces respiratory-related diseases in newborns but increases the risk of low birth weight and chorioamnionitis.