ACTION III: A multi-country, multi-centre, three-arm, parallel group

Antenatal corticosteroids in the early preterm period (<34 weeks of gestation) have been shown to clearly reduce mortality and morbidity in preterm neonates. However, there is no established evidence on the efficacy and safety of ACS use in late the preterm period (34-36 +6 weeks of gestation) on neonatal outcomes in low resource settings. While a large recent trial in the US showed a decrease in neonatal morbidity/mortality when steroids were given in the late preterm period, an earlier NIH supported Antenatal Corticosteroid Trial in resource-limited settings showed that this intervention may be ineffective or even harmful in resource-limited settings. This trial is need to provide evidence on the use of antenatal steroids in the late preterm period in resource limited setting and to thereby allow updating

of the WHO guidelines on such use.