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Recording available 2/16-5/2
Recording available 2/16-5/2
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Poster Session 3

Category: Fetal Intervention

Poster Session 3

(964) Effectiveness of Maternal Antenatal Corticosteroids for Fetal Lung Lesions: Systematic Review and Meta-Analysis by Lesion

Thursday, February 12, 2026
10:30 AM - 12:00 PM  

    Submitting Author and Presenting Author(s)

  • Shiri R. Warshawsky, BSc

    Medical Student
    University of Nicosia School of Medicine
    Sheba Medical Center, HaMerkaz, Israel

    • Coauthor(s)

  • Omri Dominsky, MD, MPH (he/him/his)

    OB\GYN resident
    Lis Hospital for Women’s Health, Tel Aviv Sourasky Medical Center
    Lis Hospital for Women’s Health, Tel Aviv Sourasky Medical Center, HaMerkaz, Israel

  • YY

    Yariv Yogev, MD

    Lis Hospital for Women’s Health, Tel Aviv Sourasky Medical Center Gray Faculty of Medicine, Tel Aviv University, Israel
    Lis Hospital for Women’s Health, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel

  • Yair J. Blumenfeld, MD

    Professor of Obstetrics and Gynecology, MFM
    Stanford Medicine
    Stanford Medicine, California, United States

Objective:
 
Maternal antenatal corticosteroids (ACS) have been proposed to improve outcomes in fetuses with large congenital lung lesions, though efficacy may vary by lesion type. We systematically evaluated the effectiveness of ACS for large fetal lung lesions, comparing historic Stocker’s CPAM-focused classification (sonographic microcystic vs macrocystic lesions) to contemporary schemes distinguishing CPAM, bronchopulmonary sequestration (BPS), hybrid lesions, bronchogenic cysts, and congenital lobar overinflation (CLE).

Study Design:
A PRISMA-compliant systematic review and meta-analysis was conducted. MEDLINE, Embase, and Scopus were searched through December 2024. Studies reporting outcomes after maternal ACS for mostly large (CPAM volume ratio (CVR) > 1.6) lesions were included. Eight observational cohorts (n=177 fetuses) met criteria; no RCTs were identified. Primary outcomes included: change in CVR, hydrops resolution, and perinatal survival. Subgroup analyses included lesion type and number of ACS courses.

Results:

1. Overall, ACS was associated with a significant reduction in CVR (pooled mean decrease ≈1.0; p< 0.001), though with considerable heterogeneity (I² ≈ 70%).



2. Among fetuses unresponsive to a single course, additional ACS courses provided a more limited incremental benefit, with lower hydrops resolution rates (56% vs 88%; p< 0.01) and similar survival (85–90%).



3. Studies applying the original micro- vs macrocystic classification reported greater CVR reductions (40–60%), hydrops resolution (75–80%), and high perinatal survival (85–100%) following a single ACS course compared with more recent lesions-specific reports.



4. Lesion-specific analysis confirmed significantly greater CVR reduction and hydrops resolution in CPAM versus non-CPAM lesions.


Conclusion:
A single course of maternal ACS is highly effective for reducing lesion size and resolving hydrops in fetuses with microcystic CPAMs. Other lesions demonstrate more limited steroid responsiveness. Additional ACS courses confer diminishing benefit in all lesion types.