- High doses of oral corticosteroids during pregnancy are associated with increased risk for preterm birth.
Why this matters
- Women using oral corticosteroids during pregnancy need close antepartum surveillance.
- High cumulative dose after 139 gestation days was associated with increased risk for preterm birth (adjusted HR, 2.45; 95% CI, 1.32-4.56).
- High cumulative oral corticosteroid dose during the first 139 gestational days increased the risk of preterm birth (adjusted risk ratio, 4.77; 95% CI, 2.76-8.26).
- Low cumulative dose was not associated with preterm birth.
- Prospective cohort study.
- Cohort was obtained from the MotherToBaby Pregnancy Studies, a self-referred and physician-referred cohort of pregnant participants concerned about teratogenic exposures during pregnancy and lactation.
- Subcohorts included patients with rheumatoid arthritis (n=528), IBD (n=217), and asthma (n=234).
- Up to 4 semistructured telephone interviews were conducted at enrollment (prior to 20 weeks of gestation), around 24 and 32 weeks, and after delivery.
- Main outcome was gestational age at delivery.
- Exposure of interest was oral corticosteroids.
- Funding: Eunice Kennedy Shriver National Institute of Child Health & Human Development; NIH.
- Small numbers in subcohorts.
- Unable to account for effects of oral corticosteroid dose and disease severity changes.