Comparative Analysis of Corticosteroid Therapy in Pregnant Women with COVID-19: Evaluating Glycemic Control and Transient Hyperglycemia

Abstract

Background: Corticosteroid administration may impair blood sugar control and cause other adverse effects in pregnant women with moderate to severe COVID-19. To our knowledge, there have been no studies on the effect of corticosteroid therapy on pregnant women with COVID-19 infection in terms of hyperglycemia or insulin needs. Objectives: The purpose of this study was to compare 2 different regimens of corticosteroid therapy, specifically dexamethasone, and methylprednisolone, in terms of their impact on newly diagnosed hyperglycemia in pregnant women infected with COVID-19, as well as the duration of this condition. Methods: The current cohort study was conducted from August to November 2021 on hospitalized pregnant women with severe COVID-19. They received either the first protocol, which involved daily administration of 2 mg/kg of methylprednisolone intravenously, or the second protocol, which included daily intravenous administration of 6 mg of dexamethasone. The study aimed to compare the incidence and duration of hyperglycemia until delivery between these 2 groups. Results: A total of 59 participants were recruited after meeting the inclusion criteria. There were no significant differences in the demographic and clinical characteristics of patients between the 2 groups. Among the 59 pregnant women included in the study, 24 (40.7%) developed hyperglycemia that required insulin therapy. The incidence of hyperglycemia did not significantly differ between the 2 treatment regimens (P-value = 0.069). In the follow-up period, hyperglycemia resolved in both groups within up to 4 weeks after treatment, and they no longer required insulin. Conclusions: Corticosteroid-treated pregnant patients are associated with transient hyperglycemia, the incidence of which is unrelated to the type of corticosteroid used. Therefore, corticosteroid administration should be initiated with caution and monitored appropriately in pregnant women with COVID-19 infection.