Use of inhaled corticosteroids during pregnancy and risk of pregnancy induced hypertension: nested case-control study

• Published in: BMJ 2005-01, Vol.330 (7485), p.230-233
• Main Authors: Martel, Marie-Josée, Rey, Évelyne, Beauchesne, Marie-France, Perreault, Sylvie, Lefebvre, Geneviève, Forget, Amélie, Blais, Lucie
• Format: Article
• Language: English
• Subjects: Administration, Inhalation; Adolescent; Adrenal Cortex Hormones - administration & dosage; Adrenal Cortex Hormones - adverse effects; Adult; Agonists; Anti-Asthmatic Agents - administration & dosage; Anti-Asthmatic Agents - adverse effects; Arterial hypertension. Arterial hypotension; Asthma; Asthma - drug therapy; Biological and medical sciences; Blood and lymphatic vessels; Cardiology. Vascular system; Case-Control Studies; Chronic illnesses; Clinical manifestations. Epidemiology. Investigative techniques. Etiology; Corticosteroids; Dosage; Drug dosages; Drug use; Ethnicity; Female; General aspects; Health risk assessment; Hospitals; Humans; Hypertension; Hypertension - chemically induced; Medical sciences; Pre-Eclampsia - chemically induced; Preeclampsia; Pregnancy; Pregnancy Complications - drug therapy; Pregnancy Complications, Cardiovascular - chemically induced; Pregnancy induced hypertension; Pregnancy Outcome; Prescription drugs; Primary Care; Risk Factors; Steroids; Studies; Womens health
• ISSN: 0959-8138; 0959-8146; 1468-5833; 1756-1833
• DOI: 10.1136/bmj.38313.624352.8F

Abstract Objective To determine whether the use of inhaled corticosteroids during pregnancy increases the risk of pregnancy induced hypertension and pre-eclampsia among asthmatic women. Design Nested case-control study. Setting Three administrative health databases from Quebec: RAMQ, MED-ECHO, and Fichier des événements démographiques. Participants 3505 women with asthma, totalling 4593 pregnancies, between 1990 and 2000. Main outcome measuresPregnancy 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). Conclusion 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.