Use of inhaled corticosteroids during pregnancy and risk of pregnancy induced hypertension: nested case-control study.
OBJECTIVE
To determine whether the use of inhaled corticosteroids during pregnancy increases the risk of pregnancy induced hypertension and pre-eclampsia among asthmatic women.


METHODS
Nested case-control study.


METHODS
Three administrative health databases from Quebec: RAMQ, MED-ECHO, and Fichier des evenements demographiques.


METHODS
3505 women with asthma, totalling 4593 pregnancies, between 1990 and 2000.


METHODS
Pregnancy induced hypertension and pre-eclampsia.


RESULTS
302 cases of pregnancy induced hypertension and 165 cases of pre-eclampsia were identified. Use of inhaled corticosteroids from conception until date of outcome was not associated with an increased risk of pregnancy induced hypertension (adjusted odds ratio 1.02, 95% confidence interval 0.77 to 1.34) or pre-eclampsia (1.06, 0.74 to 1.53). No significant dose-response relation was observed between inhaled corticosteroids and pregnancy induced hypertension or pre-eclampsia. Oral corticosteroids were significantly associated with the risk of pregnancy induced hypertension (adjusted odds ratio 1.57, 1.02 to 2.41), and a trend was seen for pre-eclampsia (1.72, 0.98 to 3.02).


CONCLUSIONS
No significant increase of the risk of pregnancy induced hypertension or pre-eclampsia was detected among users of inhaled corticosteroids during pregnancy, while markers of uncontrolled and severe asthma were found to significantly increase the risks of pregnancy induced hypertension and pre-eclampsia.
Martel
Marie-Josée
MJ
Faculty of Pharmacy, Université de Montréal, CP 6128, Succursale Centre-ville, Montreal, QC, Canada H3C 3J7.
Rey
Evelyne
E
Beauchesne
Marie-France
MF
Perreault
Sylvie
S
Lefebvre
Geneviève
G
Forget
Amélie
A
Blais
Lucie
L
D000280:Administration, Inhalation; D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage* / Q000009:adverse effects; D000328:Adult; D018927:Anti-Asthmatic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D001249:Asthma / Q000188:drug therapy; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D006973:Hypertension / Q000139:chemically induced*; D011225:Pre-Eclampsia / Q000139:chemically induced; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy; D011249:Pregnancy Complications, Cardiovascular / Q000139:chemically induced*; D011256:Pregnancy Outcome; D012307:Risk Factors
D000305:Adrenal Cortex Hormones; D018927:Anti-Asthmatic Agents