Kishwar Azad and Anthony Costello emphasise maternal sepsis as a concern but cite only one trial in which dexamethasone resulted in a significant increase in fever that required antibiotic treatment compared with controls.
Kishwar Azad and Anthony Costello raise three important questions with respect to the efficacy, safety, and the appropriate gestational age at which to give corticosteroids to patients in low-income countries.
The Comment by Kishwar Azad and Anthony Costello opposing scale-up of antenatal corticosteroids misdirects the discussion of this topic towards speculation about differences in low-income settings.
We disagree with Azad and Costello’s comment about the effect of antenatal corticosteroid treatment on respiratory distress in infants at 34 weeks’ gestation.
Authors Kishwar Azad and Anthony Costello respond to 5 correspondence letters submitted to The Lancet the use of antenatal corticosteroids to reduce preterm deaths in low-income settings.
Demand and supply-side strategies to improve maternal and newborn health care can be cost-effective, though the evidence is limited by the paucity of high quality studies and the use of disparate cost-effectiveness measures.
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