POS0696 DOES PREDNISONE USE DURING PREGNANCY IN WOMEN WITH RHEUMATOID ARTHRITIS INDUCE INSULIN RESISTANCE IN THE OFFSPRING?

Abstract

BackgroundThe use of long-term corticosteroids during pregnancy has been growing over the past decades1. Corticosteroids can be given when an auto-inflammatory disease like rheumatoid arthritis (RA) is too active. Several studies have shown that long-term corticosteroids use in pregnancy is associated with maternal and fetal adverse outcomes, like preeclampsia, shorter gestational age, lower birth weight and rapid catch-up growth 1-3. These last two outcomes could influence the insulin resistance later in life4.ObjectivesDoes prednisone use in pregnant women with RA induces insulin resistance in the offspring?Methods103 children were included after their mother had participated in a prospective cohort study on RA and pregnancy. 42 children were in utero exposed to prednisone and 61 were non-exposed. To assess insulin resistance, we measured Homeostasis Model of Assessment Insulin Resistance (HOMA-IR), serum adiponectin and lipid levels, corrected for body fat distribution.ResultsThere was no difference in mean HOMA-IR (SD) between the children who were prednisone-exposed in utero (1.10 (0.84)) and those non-exposed (1.09 (0.49)). No difference was found in mean adiponectin (SD) level, 16.45 (4.06) µg/mL and 15.40 (3.59) µg/mL, respectively. Also no difference was found in body fat distribution or lipids such as total cholesterol, fasting triglyceride or high-density lipoprotein.ConclusionChildren who are prednisone-exposed in utero have no increased risk for insulin resistance at the age of approximately 7-years. This findings are reassuring, but further research has to be performed to evaluate if prednisone-exposure in utero has no other negative effects on the long-term and if insulin resistance remains absent in the future.