Impact of Antenatal Corticosteroids on Cortisol and Glucose Homeostasis Levels in Preterm Neonates: A Meta-Analysis.

Antenatal corticosteroids (ACS) are widely used to reduce respiratory distress syndrome (RDS) in preterm neonates, enhancing neonatal outcomes. However, the potential effects of ACS on other aspects of neonatal health, such as cortisol levels and glucose regulation, remain a concern. This study examines whether ACS administration impacts cortisol and glucose homeostasis in preterm infants by analyzing data from 14 selected studies. Using a random-effects model, we found no significant impact of ACS on cortisol levels (mean differences (MD) 2.23, confidence interval (CI) 5.26 to -0.80) or blood glucose levels (standard mean differences (SMD) 0.18, CI 0.00 to 0.35). Additionally, there was no notable difference in hypoglycemia risk between groups receiving ACS and those unexposed (odds ratio (OR) 1.46, CI 0.99 to 2.17). Subgroup and sensitivity analyses reinforced these findings, underscoring their robustness, and risk-of-bias assessment confirmed a low risk across the included studies. Our findings support the safety of ACS for cortisol and glucose levels in preterm infants, affirming its continued use for lung development while recommending vigilant blood glucose monitoring to manage potential hypoglycemia. These results provide essential insights for neonatal care protocols, contributing to the overall welfare of premature infants.