REMARKS Q The GDG acknowledged the paucity of evidence on the benefits of antenatal corticosteroid therapy in this subgroup of women. However, the group placed its emphasis on the overall benefits of antenatal corticosteroids in preterm infants, the potential benefits in terms of reducing the higher risk of newborn respiratory morbidity posed by maternal diabetes, and the potential impact on overall newborn survival. Q The GDG considered the concern about the maternal hyperglycemic effect of antenatal corticosteroids, but agreed that it was insufficient to counterbalance the potential benefits for the baby if appropriate measures are taken to ensure glycemic control. Q Clinicians should ensure strict control of maternal blood glucose prior to and/or during pregnancy to reduce the risk of newborn respiratory distress syndrome, and ensure neonatal glucose monitoring. Q Delay in fetal lung maturity is generally more frequent in pregnant women with diabetes compared with the general obstetric population. Therefore, in pregnant women with poorly controlled diabetes, the use of corticosteroids could also be considered at >34 weeks of gestation. Q The GDG reaffirms that all pre-conditions outlined for antenatal corticosteroid therapy in Recommendation 1.0 apply.

Implementation considerations outlined in Table 2.