Sean W.D. CarterAgnihotri BiswasHunna J. WatsonHugh IpErin L. FeeK.H.W. SeahYusaku KumagaiZubair AminMahesh ChoolaniAlan Jobe2026-03-222026-03-22202510.1080/14656566.2025.2475190https://doi.org/10.1080/14656566.2025.2475190https://andeanlibrary.org/handle/123456789/85725Citaciones: 5Our assessment is that: i) Currently used, high dose ANS regimens can induce multi-system changes in the fetus that alter growth and development, potentially increasing long-term disease risk; and ii) relative risks likely increase proportionally to the magnitude and duration of steroid exposure, in late preterm and term ANS use, and in off-target treatments. A single course of ANS therapy to at risk women between 24- and 34-weeks' gestation is well justified. Efforts should be made to improve dosing and patient selection. At periviable gestations, the high immediate risk of serious disease or death justifies modest long-term risks. At late preterm and term gestations, where steroids do not provide notable survival or health benefits, supporting routine ANS use is more difficult.enMedicineGestationRespiratory distressIntensive care medicineDosingAdverse effectRisk assessmentPregnancyPediatricsDiseasereview