Abstract
Aims. Antenatal dexamethasone administration for fetal lung development may impair maternal glucose tolerance. In this study, we investigated whether glucose and insulin levels differed among singleton and twin pregnancies and pregnancies with impaired glucose tolerance (IGT) after treatment with dexamethasone. Methods. Singleton pregnancies, twin pregnancies, and pregnancies with IGT between 28 and 33 weeks of gestation whose mothers were treated with dexamethasone were enrolled in this study. Exclusion criteria included gestational hypertension, diabetes, renal disorders, and infectious diseases. The fasting plasma glucose and insulin levels were checked before administration and 24 h, 48 h, and 72 h after treatment was completed. Results. Mean glucose levels were significantly higher in the twin pregnancy and IGT groups at 24 h and 48 h after the administration of dexamethasone than those in the singleton pregnancy group (P < 0.05). Although there was no significant difference in glucose levels before administration and 72 h after dexamethasone administration among the three groups, insulin levels in the IGT group were significantly higher (P < 0.05). Insulin levels in the singleton pregnancy group at 24 h and 48 h after treatment were significantly lower than in the twin and IGT groups. Conclusion. The effects on maternal fasting blood glucose and insulin levels of dexamethasone administrated to promote fetal lung maturation correlated with embryo number and the presence of IGT.
Highlights
The most common cause of deaths among preterm babies is respiratory distress syndrome (RDS); antenatal corticosteroid (ACS) treatment for pregnant women at risk of preterm birth is an established intervention for the prevention of RDS
In 1994, a National Institutes of Health (NIH) consensus conference recommended that women at risk of preterm birth before 34 weeks of gestation, who delivered within 7 days, should routinely be given a course of ACS [3]
We investigated whether glucose and insulin levels differ after the administration of dexamethasone among singleton and twin pregnancies and in pregnancies with impaired glucose tolerance (IGT) [6]
Summary
The most common cause of deaths among preterm babies is respiratory distress syndrome (RDS); antenatal corticosteroid (ACS) treatment for pregnant women at risk of preterm birth is an established intervention for the prevention of RDS. Liggins and Howie first described this indication in 1972, when they demonstrated that ACS could reduce the risk of neonatal RDS from 25.8% to 9.0%, and the rate of neonatal mortality dropped from 15.0% to 3.2% [1, 2]. The incidence and mortality rates of RDS, intraventricular hemorrhage, and necrotizing enterocolitis in preterm infants have been significantly reduced. To what extend short-term use of corticosteroids for fetal lung maturation affects fasting blood glucose and insulin levels in normal singleton pregnancies, normal twin pregnancies, and IGT pregnancies who do not require insulin treatment is still uncertain. We investigated whether glucose and insulin levels differ after the administration of dexamethasone among singleton and twin pregnancies and in pregnancies with impaired glucose tolerance (IGT) [6]
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