Downloaded from http://journals.lww.com/obgynsurvey by BhDMf5ePHKbH4TTImqenVCbF2BRbWAbdpB0FJ9aTfBLceAvdjDi9qcs97Wh2mDfdgof+W9hsSuc= on 05/31/2020 CHIEF EDITOR’S NOTE: This article is part of a series of continuing education activities in this Journal through which up to 36 AMA PRA Category 1 Credits™ can be earned in 2020. Instructions for how CME credits can be earned appear on the last page of the Table of Contents. Antenatal Corticosteroids and Magnesium Sulfate for Improved Preterm Neonatal Outcomes: A Review of Guidelines Ioannis Tsakiridis, MSc,* Apostolos Mamopoulos, PhD,† Apostolos Athanasiadis, PhD,† and Themistoklis Dagklis, PhD‡ *Resident Assistant, †Professor, and ‡Assistant Professor, Third Department of Obstetrics and Gynaecology, Faculty of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece Importance: In cases of anticipated preterm delivery, corticosteroids for fetal lung maturation and magnesium sulfate for fetal neuroprotection may improve neonatal outcomes. Objective: The aim of this study was to summarize and compare published guidelines from 4 leading medical societies on the administration of antenatal corticosteroids and magnesium sulfate. Evidence Acquisition: A descriptive review of major national guidelines on corticosteroids and magnesium sulfate was conducted: National Institute for Health and Care Excellence on “Preterm labour and birth,” World Health Organization on “WHO recommendations on interventions to improve preterm birth outcomes, ” American College of Obstetricians and Gynecologists on “Antenatal corticosteroid therapy for fetal maturation” and “Mag- nesium sulfate use in obstetrics,” and Society of Obstetricians and Gynecologists of Canada on “Antenatal cor- ticosteroid therapy for improving neonatal outcomes” and “Magnesium sulphate for fetal neuroprotection.” Results: A variation in the appropriate timing of administration exists, whereas repeated courses are not rou- tinely recommended for corticosteroids or magnesium sulfate. In addition, the recommendations are the same for singleton and multiple gestations, and no specific recommendation exists according to maternal body mass index. Finally, a variation in guidelines regarding the administration of corticosteroids before cesarean delivery exists. Conclusions: The adoption of an international consensus on corticosteroids and magnesium sulfate may in- crease their endorsement by health care professionals, leading to more favorable neonatal outcomes after pre- term delivery. Target Audience: Obstetricians and gynecologists, family physicians. Learning Objectives: After participating in this activity, the learner should be better able to identify the appro- priate indications for the administration of corticosteroids and magnesium sulfate; describe the effectiveness and associated risks of corticosteroids and magnesium sulfate; and explain the timing and schemes of corticoste- roids and magnesium sulfate administration. Preterm delivery (PTD), defined as delivery before 37 gestational weeks, is the most important determinant of adverse outcomes in newborns. 1 Preterm delivery af- fects about 15 million pregnancies per year and represents the leading cause of neonatal morbidity and mortality. 2,3 More specifically, it is associated with high risks of re- spiratory distress syndrome (RDS), intraventricular hemorrhage (IVH), and long-term neurodevelopmental All authors, faculty, and staff in a position to control the content of this CME activity and their spouses/life partners (if any) have disclosed that they have no financial relationships with, or financial interests in, any commercial organizations relevant to this educational activity. Correspondence requests to: Ioannis Tsakiridis, MSc, Third Department of Obstetrics and Gynaecology, Faculty of Medicine, Aristotle University of Thessaloniki, Konstantinoupoleos 49, 54642, Thessaloniki, Greece. E-mail: igtsakir@auth.gr. www.obgynsurvey.com | 299 Volume 75, Number 5 OBSTETRICAL AND GYNECOLOGICAL SURVEY Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved. CME REVIEW ARTICLE 12 Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.