Applikation antenataler Kortikosteroide: aktueller Wissensstand

Zusammenfassung

Die einmalige Gabe von Kortikosteroiden vor 34 + 0 SSW bei drohender Frühgeburt ist ein Standard in der heutigen Geburtshilfe und in den Leitlinien der verschiedensten Länder fest verankert. Trotz der anscheinend überzeugenden Datenlage sind allerdings zahlreiche Teilaspekte zu dieser Intervention nur wenig geklärt. So war bisher offen, welches Kortikosteroid die optimale Wirkung erzielt. Es gibt kaum Studien zur Dosierung, zur zirkadianen Rhythmik, zum Zeitfenster der Wirksamkeit oder zur Nutzen-Schaden-Bilanz einer wiederholten Gabe. Da in den vorliegenden Studien selten Patientinnen vor 24 + 0 SSW eingeschlossen wurden, haben wir nur wenig Information zum möglichen Nutzen einer Kortikosteroid-Applikation vor diesem Zeitpunkt. Bei einer antenatalen Gabe von Kortikosteroiden nach 34 + 0 SSW stehen dem kurzfristigen Nutzen möglicherweise langfristige Beeinträchtigungen in der psychomotorischen Entwicklung gegenüber. Die vorliegende Arbeit fasst den derzeitigen Wissensstand zu diesen Fragen zusammen.

Schlüsselwörter

Kortikosteroide - Frühgeburt - Dosis - Timing

Publication History

Received: 08 April 2021

Accepted after revision: 20 July 2021

Article published online:
11 January 2022

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