Inhaled Corticosteroids Use Is Not Associated With an Increased Risk of Pregnancy-Induced Hypertension and Gestational Diabetes Mellitus

Abstract

There have been concerns that systemic corticosteroid use is associated with pregnancy-induced hypertension (PIH) and diabetes mellitus. However, the relationship between inhaled corticosteroids (ICSs) and the risk of PIH has not been fully examined, and there was no study investigating the association between ICS use and the development of gestational diabetes mellitus (GDM). The aims of the study are to determine whether the use of ICSs during pregnancy increases the risk of PIH and GDM in women.We conducted 2 nested case-control studies utilizing the nationwide insurance claims database of the Health Insurance Review and Assessment Service (Seoul, Republic of Korea), in which 1,306,281 pregnant women who delivered between January 1, 2009 and December 31, 2011 were included. Among them, PIH cases and GDM cases were identified and matched controls were included. Conditional logistic regression analyses adjusted by other concomitant drugs use during and before pregnancy and confounding covariates including comorbidities were performed.Total 43,908 PIH cases and 219,534 controls, and 34,190 GDM cases and 170,934 control subjects were identified. When other concomitant drugs use during pregnancy was adjusted, ICS use was associated with an increased rate of PIH (adjusted odds ratio, 1.40 [95% CI, 1.05–1.87]). ICS medication possession ratios and cumulative doses were associated with an increased risk of PIH. However, the statistical significance was not found in other models. In both unadjusted and adjusted multivariable models, ICSs use was not associated with increase in the risk of GDM.ICSs use is not associated with an increased risk of PIH and GDM.

Maternal asthma and gestational diabetes mellitus: Exploration of potential associations

“…64 Authors adjusted for GDM-associated comorbidities including history of GDM, pregnancy-induced hypertension and impaired glucose metabolism, and concomitant respiratory medication use. 64 There was no significant association between ICS use, with or without LABA, in the 180 days preceding GDM diagnosis, and GDM risk. 64 An ICS medication possession rate of 0–0.3 versus 0, was associated with a 20% lower odds of GDM after adjustment for concomitant respiratory medication use, age, comorbidities and healthcare utilisation during pregnancy; 64 yet, further adjustment for medication use pre- pregnancy removed significance.…”

“…64 An ICS medication possession rate of 0–0.3 versus 0, was associated with a 20% lower odds of GDM after adjustment for concomitant respiratory medication use, age, comorbidities and healthcare utilisation during pregnancy; 64 yet, further adjustment for medication use pre- pregnancy removed significance. 64 Thus, limited evidence to date suggests that ICS use is not associated with GDM risk, which may be attributable to a lack of biological effect of ICS on glucose control during pregnancy. 65…”

“…67 Given the shared risk factors and pathogenesis, OCS use may increase GDM risk. 64 OCSs are commonly used to manage severe uncontrolled asthma and acute exacerbations of asthma, 68 and, in women who receive them preceding or during pregnancy, could potentially impact glucose control and GDM risk. However, no studies have examined asthma-related OCS use and GDM risk , with insufficient evidence in other diseases to support a link between OCS exposure and GDM development.…”

Inhaled Corticosteroids Use Is Not Associated With an Increased Risk of Pregnancy-Induced Hypertension and Gestational Diabetes Mellitus

“…In the article, “Inhaled Corticosteroids Use Is Not Associated With an Increased Risk of Pregnancy-Induced Hypertension and Gestational Diabetes Mellitus”, [ 1 ] which appeared in Volume 95, Issue 22 of Medicine , two authors’ affiliations appeared incorrectly. Eun Jin Janh's affiliation also includes “Department of Information Statistics, Colloge of Natural Science, Andong National University, Andong, Republic of Korea.” Jimin Kim's affiliation should have included “’Department of Health Policy and Hospital Management, Graduate School of Public Health, Korea University, Seoul, Republic of Korea.”…”

Inhaled Corticosteroids Use Is Not Associated With an Increased Risk of Pregnancy-Induced Hypertension and Gestational Diabetes Mellitus

“…In the article “Inhaled Corticosteroids Use Is Not Associated With an Increased Risk of Pregnancy-Induced Hypertension and Gestational Diabetes Mellitus: Two Nested Case-Control Studies”, 1 which appeared in Volume 95, Issue 22 of Medicine , one of Dr. Jimin Kim's affiliations was originally omitted.…”