Background : Caesarean sections continue to increase day by day in both developed and developing countries, which is associated with increased respiratory distress syndrome (RDS), the key reason for early neonatal morbidity and mortality.   
Objective: To assess the effect of routine prophylactic corticosteroids before elective caesarean section after 37 weeks of gestational age, on neonatal respiratory morbidity. Methods: A prospective observational study was conducted on all pregnant women undergoing elective caesarean sections between 37-42 weeks at Ain Shams University Maternity Hospital. Over an 8- month period (from November 2020 to June 2021), 1105 cases were divided into the exposed group (A), (N = 877) who received prophylactic dexamethasone, and 228 cases in the non-exposed group (B) who did not receive dexamethasone. Outcome measures were the incidence of transient tachypnea of the newborn, and NICU admissions due to respiratory morbidity. Data were analyzed using SPSS 22.  
Results: Overall, there was no statistically significant difference in the incidence of TTN or RDS. No cases of TTN were found in exposed subgroup, versus 1 (0.4%) in non-exposed group (p= 0.745). The respiratory distress (RDS) in the exposed subgroup was 4 cases (16.7%) versus 18 (7.9%) in
non-exposed group (p = 0.148). While the admission to the neonatal intensive care unit (NICU) due to respiratory morbidity after an elective caesarean section was 4 cases (16.7%) in the exposed subgroup versus 19 cases (8.3%) in the non-exposed group (p = 0.178).  
Conclusion: Routine administration of prophylactic antenatal corticosteroids before elective caesarean sections at term does not reduce the risk of admission to the NICU compared to non- administration.