Glucocorticoid use during pregnancy linked to endocrine, metabolic disorders
MedWire News: Study findings suggest that maternal use of inhaled glucocorticoids for treating asthma during pregnancy increases the risk for endocrine, metabolic, and nutritional disorders in the child but does not impact on the likelihood for other diseases.
"Our data are mostly reassuring and support the use of inhaled glucocorticoids in pregnancy," said study co-author Marion Tegethoff (University of Basel, Switzerland) in an associated press release.
Gunther Meinlschmidt (University of Basel) and colleagues estimated associations between use of inhaled glucocorticoids for asthma treatment during pregnancy and pediatric diseases, using data from 4083 mother-child pairs who took part in the Danish National Birth Cohort during 1996-2002.
In total, 79.9% of women had been treated with budesonide, 17.6% with fluticasone, 5.4% with beclomethasone, and 0.9% with other or unspecified glucocorticoids.
At the end of follow-up, children were aged an average of 6.1 years.
The team found that use of glucocorticoid inhalants during pregnancy was associated with a significantly increased risk for the first diagnosis of endocrine and metabolic disorders (hazard ratio [HR]=1.62), but not for diseases in any other category.
When analyses were repeated by stratifying them for propensity score data, the researchers found this risk was even more pronounced, increased to a HR of 1.84. Furthermore, glucorticoid inhalation due to asthma during pregnancy was also significantly related to an increased risk for diseases of the digestive system (HR=1.54).
Due to the high number of women exposed to budesonide during pregnancy, the team then repeated the analyses in this subsample of women and found no significant change in risk (HR=1.72).
Case-control analyses revealed that cases with a diagnosis in the most common subcategory of metabolic disorder were significantly more likely to be exposed to maternal glucocorticoid inhalation during pregnancy (43.9 vs 29.9%).
The researchers note study limitations including lack of data on daily inhalation doses, use of self-report of maternal asthma, and the study's focus on glucocorticoid inhalation rather than other active ingredients or glucocorticoids administered by other routes.
Writing in the American Journal of Respiratory Research and Critical Care Medicine, the researchers conclude: "Our results are mostly reassuring regarding the use of glucocorticoid inhalation during pregnancy, while they suggest taking a closer look at its relevance for endocrine and metabolic disturbances during childhood."
By Ingrid Grasmo