Background: Antenatal corticosteroids (ACS) are well established to reduce neonatal morbidity and mortality when given prior to pre-term birth. Corticosteroids are known to dysregulate glucose metabolism outside of pregnancy. Understanding the implications of this short course of ACS within the context of diabetes in pregnancy for both maternal and neonatal outcomes is imperative. However, there is a paucity of data regarding the effects of ACS on maternal glycaemic regulation in women with and without diabetes and its associated short term neonatal outcomes.
Methods: We undertook a comprehensive literature review using PubMed and Embase with key search terms antenatal corticosteroids, pregnancy and glycaemic outcomes. Using defined limitations to retrieve all publications reporting on maternal glycaemic outcomes, risk factors for hyperglycaemia and glycaemic management following ACS administration, 338 publications were identified. Title, abstract reviews, and subsequent full text screen against our defined inclusion and exclusion criteria were conducted.  
Results: A total of 18 publications were included in this review. These publications comprised of five randomised controlled trials, six retrospective cohort studies and seven prospective cohort studies. Glycaemic outcomes were analysed and reported according to key themes including the prevalence, temporal profile and severity of hyperglycaemia. Hyperglycaemia was found to be a common and transient side effect of ACS therapy, regardless of maternal diabetes status, however, reported to be more severe in women with diabetes. The primary risk factors for hyperglycaemia following ACS explored by these papers included BMI, multiple gestations and tocolytic agents used in conjunction with ACS. However, further research is required to clarify the relationship between these risk factors and maternal hyperglycaemia following ACS. It was also found that there is no consensus regarding the management of ACS induced maternal hyperglycaemia and it is uncertain whether appropriate management of maternal hyperglycaemia translates into clinically relevant improvements in neonatal outcomes.

Conclusions: ACS induced maternal hyperglycaemia is common in women independent of diabetes status, however more common in women with diabetes. There is no consensus regarding the optimal management of maternal hyperglycaemia nor if management translates into improved neonatal outcomes. Further research is required to evaluate the effect of the type of diabetes and other risk factors which may influence the frequency and severity of ACS induced maternal hyperglycaemia, impact on neonatal outcomes, as well as strategies to improve glycaemic control following ACS and its cost effectiveness.