Oral Steroids & Pregnancy: SKKU Research on Safety

by Grace Chen

steroid Use During Pregnancy Doesn’t Elevate Gestational diabetes Risk, new Study Finds

A large-scale analysis of over one million pregnant women reveals that the use of oral steroids during pregnancy is not associated wiht an increased risk of gestational diabetes, offering reassurance to expectant mothers requiring these medications.The findings, published December 1 in the prestigious journal JAMA Internal Medicine, utilized extensive healthcare data to address growing concerns surrounding the potential metabolic effects of steroids.

Addressing Concerns About Steroid Use in Pregnancy

Oral steroids are frequently prescribed to women of childbearing age for a range of conditions, including allergies, autoimmune diseases, and infertility treatments. With increasing rates of steroid use among pregnant women, a critical need emerged to establish evidence-based guidelines regarding their safety during pregnancy. Prior concerns centered on the drugs’ potential impact on glucose metabolism, raising fears of increased gestational diabetes incidence.

Did you know?– Gestational diabetes affects approximately 2-10% of pregnancies each year in the U.S., potentially leading to complications for both mother and baby.

Analyzing Data from Over One Million Pregnancies

Researchers from Sungkyunkwan University meticulously analyzed data from more than 1 million pregnant women who gave birth between 2010 and 2021,ensuring all participants had no prior history of diabetes before becoming pregnant. The team employed propensity score weighting – a statistical method used to account for differences in characteristics between groups – to correct for factors such as age, lifestyle, existing health conditions (comorbidities), and other medications. A validated algorithm was used to accurately define cases of gestational diabetes.

Pro tip:– Maintaining a healthy weight and diet before and during pregnancy can help reduce the risk of developing gestational diabetes.

Key Findings: no Increased Risk Observed

The analysis revealed that approximately 80,000 women – representing 6% of the study population – used oral steroids during their pregnancies. Though, the research team found no statistically significant increase in the risk of developing gestational diabetes compared to women who did not use steroids. The hazard ratio was reported as 1.01, with a 95% confidence interval of 0.99-1.03, indicating no meaningful difference between the two groups. This consistent finding persisted across various sub-analyses examining different types, dosages, and durations of steroid use.

Reader question:– If I need steroids during pregnancy, should I be closely monitored for gestational diabetes? Discuss this with your doctor to determine the best course of action.

Expert Commentary and implications for Patient Care

“This study demonstrates that pregnant women who require steroid treatment can generally continue their medication without undue worry about developing gestational diabetes,” explained a lead researcher from Sungkyunkwan University’s College of Pharmacy. “It underscores the importance of appropriate disease management throughout pregnancy.”

Though,the researchers cautioned that a slight signal suggesting a potentially increased risk was observed during the 4th to 6th week of pregnancy,warranting further inquiry.

Funding and Publication Details

The study was supported by the National Research Foundation of Korea as part of a broader initiative focused on evaluating drug use and long-term health outcomes in children. The research was published online December 1 in JAMA Internal Medicine, a leading medical journal with an impact factor (IF) of 23.3.

[Image of Sungkyunkwan University Professor Jooyoung Shin (from left), Dr. Eunyoung Choi, and yongtae Cho, integrated master’s and doctoral program student [성균관대 제공]]

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