Inhaled Corticosteroids Use Is Not Associated With an Increased Risk of Pregnancy-Induced Hypertension and Gestational Diabetes Mellitus: Two Nested Case-Control Studies.
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.
From the National Evidence-Based Healthcare Collaborating Agency (C-HL, JK, EJJ, YJK, SC, DKK, J-JY, HIY); Division of Pulmonary and Critical Care Medicine (C-HL, J-JY), Department of Internal Medicine, Seoul National University College of Medicine; Department of Obstetrics and Gynecology (J-HL), Seoul National University College of Medicine, Seoul National University Hospital; Division of Pulmonary and Critical Care Medicine (DKK), Department of Internal Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center; Division of Pulmonary and Critical Care Medicine (HIY), Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam-Si, Republic of Korea; and Department of Health Policy and Hospital Management, Graduate School of Public Health, Korea University (JK).
Chang-Hoon
CH
Lee
Jimin
J
Kim
Eun Jin
EJ
Jang
Joon-Ho
JH
Lee
Yun Jung
YJ
Kim
Seongmi
S
Choi
Deog Kyeom
DK
Kim
Jae-Joon
JJ
Yim
Ho Il
HI
Yoon
D000280:Administration, Inhalation; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage*; D000328:Adult; D016022:Case-Control Studies; D016640:Diabetes, Gestational / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D046110:Hypertension, Pregnancy-Induced / Q000453:epidemiology*; D015994:Incidence; D016017:Odds Ratio; D011247:Pregnancy; D056910:Republic of Korea / Q000453:epidemiology; D018570:Risk Assessment; D012307:Risk Factors
D000305:Adrenal Cortex Hormones