Research Article

Nephrotoxic versus nephroprotective: what is the role of antenatal steroids in preterm neonates

Rafia Gul, Attiqua Muzamil, Samer Fatima, Sidra Niamat

Journal of Neonatal-Perinatal Medicine · Online First · Published March 7, 2026
DOI: 10.1177/19345798261431232

Antenatal Steroids in Brief

Antenatal steroids are given to mothers at risk of early delivery to help their baby’s lungs mature, but their effect on the baby’s kidneys is not well understood. This study asked whether preterm babies exposed to these steroids before birth were more or less likely to develop acute kidney injury in the newborn intensive care unit.

Key Points

• A prospective study of 399 preterm neonates in a newborn intensive care unit in Lahore, carried out between 2023 and 2025.
• Babies were grouped by their exposure to antenatal steroids, and acute kidney injury was staged using KDIGO criteria over the first 14 days.
• Acute kidney injury was less common after a complete steroid course (23.4%) than after an incomplete course (47.3%) or no exposure (45.4%), and this held after adjusting for other factors.
• The authors describe this as an association, not proof of cause and effect, so larger studies are needed.

What This Means for Parents

If your baby may be born early, your doctor may offer you antenatal steroids, a short course of injections given over one to two days. They are already known to help a premature baby’s lungs, and in this study babies whose mothers completed the full course had about half the rate of kidney injury. Timing matters, so if you have signs of early labor, go to hospital promptly so there is time to complete the course. An Antenatal Consult with a neonatologist helps you plan, and if your baby needs the NICU, the team will watch kidney function closely in the first days.

Antenatal SteroidsAcute Kidney InjuryPremature BabiesNephroprotectionRenal MaturationPerinatal Outcomes

© The Author(s) 2026. Published in the Journal of Neonatal-Perinatal Medicine. PDF shared by the authors.