Low-Dose Prednisone Exposure During Pregnancy Increases Risk of GDM and Impaired Glucose Tolerance: Study Finds
China: A recent single-center, prospective cohort study has revealed potential risks associated with the use of low-dose prednisone during pregnancy, particularly concerning glucose metabolism. The study, published in the Journal of Reproductive Immunology, found that prolonged use of low-dose prednisone during pregnancy may disrupt postprandial blood glucose levels and elevate the risk of developing gestational diabetes mellitus (GDM).
"Regular monitoring of blood glucose and C-peptide levels is advised for patients undergoing prednisone treatment during pregnancy," the researchers wrote.
In this single-center prospective cohort study, Qiaohong Wang, Department of Obstetrics and Gynecology, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China, and colleagues investigated the impact of low-dose prednisone treatment during pregnancy on blood glucose levels in patients who had experienced spontaneous abortion.
For this purpose, the researchers enrolled patients with a history of spontaneous abortion. They divided them into two groups based on whether they were exposed to low-dose prednisone during pregnancy. All participants underwent an oral glucose tolerance test (OGTT) in both early and late pregnancy, and fasting serum C-peptide and HbA1c levels were measured at the same time. The study then analyzed the incidence of diabetes mellitus (DM), impaired fasting glucose, impaired glucose tolerance, and gestational diabetes mellitus. A total of 355 patients were included in the study.
Based on the study, the researchers reported the following findings:
- No significant difference in OGTT between the two groups were observed in the first trimester.
- Patients in the prednisone group showed a significant increase in fasting serum C-peptide.
- Regarding late pregnancy, patients in the prednisone group showed a significant increase in 2-h plasma glucose.
- Patients in the prednisone group also had a higher incidence of GDM.
- Family history of DM and receiving low-dose prednisone were significantly associated with a higher risk of gestational glycometabolism abnormality in patients with spontaneous abortion.
The study found that prolonged use of low-dose prednisone during pregnancy can impair glucose tolerance in late pregnancy and increase the risk of gestational diabetes mellitus. A family history of diabetes mellitus and exposure to low-dose prednisone were identified as independent risk factors for gestational glycometabolic abnormalities.
"Based on these findings, we recommend routine monitoring of blood glucose and C-peptide levels in patients receiving prednisone during pregnancy," the researchers concluded.
Reference:
Wang, Q., Bai, W., Li, C., Zhang, X., & Zhao, A. (2024). Effect of low dose prednisone on glucose metabolism levels in patients with spontaneous abortion: A single-center, prospective cohort study. Journal of Reproductive Immunology, 166, 104395. https://doi.org/10.1016/j.jri.2024.104395
