[Glucocorticoid treatment in pregnancy; is caution the mother of wisdom?]

Timely prenatal, maternally administered, corticosteroids improve the outcome of preterm newborns. The general aim should therefore be optimal identification of actual imminent preterm birth to provide protection of all preterm infants that are at risk of a substantial level of post-natal morbidity. Unnecessary use of maternal corticosteroids by inadequate estimate of imminent preterm birth, now seems associated with mental and behavioural problems in the offspring during the life course, which calls for a more restricted use. Opportunities to reduce futile use of maternal corticosteroids in case of preterm birth might be found in better timing of administration, improved selection of women at risk and by potential restraint re-use at later gestational ages. Timing and selection can be further improved by the development of better (non-invasive) predictors to pinpoint those women who actual will deliver within 48 hours. Future prospective studies should provide additional evidence to improve antenatal corticosteroid administration.