Maternal corticosteroids raise maternal glucose and fetal insulin secretion, so the baby can drop its glucose in the first hours after birth, particularly when birth follows within a few days of the course. The risk adds to that from prematurity, growth restriction and maternal diabetes.
When a late-preterm course has been given, say so clearly at handover and in the birth record. Early feeding and timed glucose checks according to the local neonatal protocol are the standard response.
- Write the date and time of the last steroid dose on the delivery summary.
- Flag steroid exposure to the neonatal or paediatric team at birth.
- Encourage feeding within the first hour where the baby is well.
- Expect higher risk when steroids, maternal diabetes and growth restriction coincide.
Why it matters
Neonatal hypoglycaemia after steroids is predictable, so it should never be a surprise on the ward.
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