Maternal and fetal outcomes in pregnancies with long-term corticosteroid use

Abstract

Purpose Long-term corticosteroids are administered in pregnant patients with an array of autoimmune and inflammatory disorders. Our objective is to determine whether long-term corticosteroid use is associated with increased maternal and neonatal adverse outcomes. Materials and methods We performed a retrospective cohort study using the Healthcare Cost and Utilization Project—national Inpatient Sample from the USA. All pregnant patients on long-term corticosteroids were identified using International Classification of Disease-9 coding from 2003 to 2015. The effect of long-term corticosteroid use on maternal and neonatal outcomes was evaluated using multivariate logistic regression. Results Out of the 10,491,798 births included in our study, 3999 were among women with long-term use of steroids, for an overall prevalence of 38 per 100,000 births. There was a steady increase in chronic steroid use from 2 to 81 per 100,000 births over the 13-year study period (p < .0001). Women on long-term steroids were more likely to have pregnancies complicated by preeclampsia, 1.72 (1.30–2.29) and were at greater risk of preterm premature rupture of membranes, 1.63 (1.01–2.44), pyelonephritis, 4.81 (1.18–19.61), and venous thromboembolisms, 2.50 (1.32–4.73). Neonates born from mothers on long-term steroids were more likely to suffer from prematurity, 1.51 (1.13–2.05), and lower weight for gestational age, 2.10 (1.34–3.30). Conclusion Long-term corticosteroids use in pregnancy is associated with maternal and fetal adverse outcomes. These patients would benefit from close follow-up throughout their pregnancy to minimize complications.