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Oral corticosteroids in pregnancy
Corticosteroids are relatively safe to use during pregnancy from a fetal standpoint, but they may contribute to maternal hypertension and gestational diabetes. The American College of Obstetricians and Gynecologists (ACOG) provides specific recommendations for the use of corticosteroids in pregnancy.2 (ACOG website). In a study conducted of 1140 pregnant women, pregnant patients who took glucocorticoids were 20% to 60% more likely to develop gestational diabetes at delivery compared to those who didn't take the drugs, oral corticosteroids in pregnancy.3 In addition to the potential for maternal health risks related to glucocorticoids, the use of glucocorticoids has significant adverse effects on maternal and fetal nutrition, oral corticosteroids in pregnancy. Ingestion of glucocorticoids by pregnant women results in increased plasma corticosteroid levels and impairment to lactation.3 In addition, maternal hyperglycemia, high lipid-storage and metabolic acidosis occur, resulting in reduced fetal growth.4 The pregnancy associated risk of adverse effects for glucocorticoids is not known because the only reliable data on pregnancy associated risk of glucocorticoids are from small studies with limited duration.5 Studies performed to define the risk of adverse effects associated with glucocorticoids in pregnancy have all been performed by epidemiologists with a large sample size.6 In a systematic review of the efficacy of glucocorticoids during pregnancy in the Netherlands,7 13 studies found that the safety and efficacy of corticosteroids used during pregnancy was related to the duration of use and the dose, oral corticosteroids cause. A meta-analysis found no evidence of adverse effects following 3 week supplementation of 50 mg of glucocorticoids for 12 weeks in 573 women with type 1 diabetes.7 Another meta-analysis using a meta-analysis model including the original 14 studies found no evidence of safety issues in the use of glucocorticoids as a treatment for pregnancy.8 The results of an in vivo study that showed increased risk of gestational hypertension in the treatment of gestational diabetes,9 a post-marketing safety alert issued by the FDA regarding the use of corticosteroids to treat type 2 diabetes,10 and a new report from the European Food Safety Authority11 point to increased adverse effects of glucocorticoids during pregnancy compared to other anti-diabetic medications, oral corticosteroids in copd. In a study of 945 post-partum women who were taking glucocorticoids as part of the women's own therapy for type 1 diabetes, 14% of the women had gestational hypertension, 4, oral corticosteroids long term side effects.5% had gestational dysxia, and 1, oral corticosteroids long term side effects.9% had early morning or
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