Does Treatment With Antenatal Glucocorticoids for the Risk of Premature Delivery Contribute to Ketoacidosis in Pregnant Women With Diabetes Who Receive Continuous Subcutaneous Insulin Infusion (CSII)?

Antenatal corticosteroid therapy for fetal pulmonary maturation and the prevention of intraventricular hemorrhage is indicated for women who are at risk for premature delivery and results in a substantial decrease in neonatal morbidity and mortality.¹ Currently, women with maternal diabetes are at increased risk for neonatal morbidity and mortality, and it predisposes the preterm infant to respiratory distress syndrome (RDS), especially when poorly controlled diabetes gives rise to fetal hyperinsulinism that blocks surfactant production by pulmonary cells, and the use of antenatal steroids can be justified.¹