 Several randomized studies have shown that a single course of antenatal corticosteroid treatment improves the survival of preterm infants born at 24-34 weeks gestation and decreases the incidence of RDS, ICH and NEC. ANC therapy reduces the incidence of RDS by approximately 50.1,2 ANC treatment also reduces the need of exogenous surfactant 4. The protective effect against RDS is thought to be due to the structural maturation of the lungs, increased surfactant synthesis, improved resistance to lung injury and improved cardiovascular adaptation. Glucocorticoid speeds up the normal thinning of the gas-exchange walls with double capillary loops between the air sacs. ANC thus accelerates the structural development of the respiratory airways, but reduces the number of alveoli. Glucocorticoid increases surfactant synthesis by enhancing maturation of the surfactant- producing type II pneumocytes and stimulating the secretion of surfactant complex 1,6,7,8,9,40. Serial doses of ANC may possibly downregulate steroid receptors resulting in decreased or disordered surfactant production.ref ANC has not been shown to decrease the incidence of CLD at 28 days of age either in the meta-analysis or in the recent retrospective studies 2,13,14,15. 