Antenatal corticosteroids guidelines(ANC-CPG)

Evidence-based recommendations to guide decision-making in clinical practice in New Zealand and Australia.

Download: Antenatal Corticosteroid Clinical Practice Guidelines

A single course of antenatal corticosteroids has a major role in reducing death and major morbidity in babies born preterm (Lawn 2012, Roberts 2006). The evidence is less clear as to what, when, how and to whom to give antenatal corticosteroids. There is variation in the uptake of the evidence for the use of repeat courses of antenatal corticosteroids (Spencer 2014) and uncertainty about the use of antenatal corticosteroids in women with specific obstetric complications (Bonanno 2012).


  1. Lawn JE, Segre J, Buekens P, Althabe F, Belizan JM, Jobe AH, Brooke S, Hodkins S and de Graft Johnson J. Antenatal Corticosteroids for the Reduction of Deaths in Preterm Babies. Case study for the United Nations Commission for Life-Saving Commodities for Women and Children, March 2012.
  2. Roberts D and Dalziel S. Antenatal corticosteroids for accelerating fetal lung maturation for women at risk of preterm birth. Cochrane Database Syst Rev 2006;(3):CD004454.
  3. Spencer LB, Middleton, Bubner TK and Crowther CA. Antenatal corticosteroids use: a survey of current obstetric practice. Perinatal Society of Australia and New Zealand. Perth, Australia. Journal of Paediatrics and Child Health 2014;50:40–64.
  4. Bonanno C and Wapner RJ. Antenatal corticosteroids in the management of preterm birth: are we back where we started? Obstet Gynecol Clin North Am 2012; 39(1):47-63.

Advice in the form of these bi-national Clinical Practice Guidelines (New Zealand and Australia) provides evidence-based recommendations to guide decision-making in clinical practice and highlights areas requiring further research.

Aims of the Clinical Practice Guidelines

To prepare evidence-based Clinical Practice Guidelines on the use of antenatal corticosteroids given to women prior to birth to improve fetal, infant and child and adult health.

Target audience

The purpose and rationale is to provide practical, evidence-based guidance on best practice for clinical care in the use of antenatal corticosteroids targeted to the following audiences:

  • Health professionals caring for pregnant women, where the baby is at increased risk of respiratory distress syndrome due to factors such as preterm birth;
  • Health professionals caring for the infants and children born following administration of antenatal corticosteroids;
  • Pregnant women and their partners;
  • Policy makers in maternity care.

Scope of the Clinical Practice Guidelines

The scope of these Clinical Practice Guidelines is to examine the evidence for giving a woman at risk of preterm birth (<37 weeks’ gestation) a single course and/or repeat antenatal corticosteroids prior to preterm birth, for the purpose of improving health outcomes of their baby. The scope includes the use of antenatal corticosteroids for women at term gestation (37 weeks’ gestation or more) where the baby is at increased risk of respiratory distress syndrome; including women having an elective caesarean section for any indication; and women with a diagnosis of diabetes or gestational diabetes.

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