Journal of South Asian Federation of Obstetrics and Gynaecology

Register      Login

VOLUME 14 , ISSUE 2 ( March-April, 2022 ) > List of Articles

ORIGINAL RESEARCH

A Study on the Effect of Antenatal Corticosteroids on Glycemic Response in Preterm Patients

Shannon F Fernandes, Rithesh J D'Cunha, Joylene D'Almeida

Keywords : Antenatal corticosteroids, Gestational diabetes mellitus, Preterm

Citation Information : Fernandes SF, D'Cunha RJ, D'Almeida J. A Study on the Effect of Antenatal Corticosteroids on Glycemic Response in Preterm Patients. J South Asian Feder Obs Gynae 2022; 14 (2):148-151.

DOI: 10.5005/jp-journals-10006-2016

License: CC BY-NC 4.0

Published Online: 21-06-2022

Copyright Statement:  Copyright © 2022; The Author(s).


Abstract

Aim: Antenatal corticosteroids (ACS) are recommended for use in antenatal mothers at risk of preterm delivery before 34 weeks. One common side effect is the propensity to cause hyperglycemia. Our study aimed at characterizing glycemic response to betamethasone in preterm women and compared this response in patients with gestational diabetes mellitus (GDM) and those without GDM. Materials and methods: After ethical clearance, 160 preterm antenatal patients who required ACS were included between 28- and 34-week periods of gestation. They were allotted into two groups: those with GDM and those without GDM. Fasting blood sugar (FBS) and postprandial blood sugar (PPBS) were followed for 4 days after betamethasone administration. Results: A total of 54.65% showed an elevated FBS in the normal group on D2 and this reduced to 29.53% on D4 and 19.76% on D5. Similarly, PPBS was elevated in 54.65% on D2 and reduced to 26.7% on D4 and 13.95% on D5, whereas in the GDM group, FBS remained elevated on D2–D4 in 77.02, 81.08, and 71.62%, respectively, and started showing a downward trend with 45.94% on D5. Similarly, PPBS was elevated in 78.38, 77.03, and 67.57% on D2–D4, respectively, and reduced slightly to 56.76% on D5. Conclusion: Our findings highlight the need for monitoring the glycemic levels even up to 5 days after ACS administration. Clinical significance: With the increasing prevalence of GDM in antenatal mothers in India, this study highlights the need for more stringent glucose monitoring after steroid administration and also the need for protocols on the frequency of monitoring and dosage of insulin regimen.


PDF Share
  1. Effect of corticosteroids for fetal maturation on perinatal outcomes. NIH Consens Statement 1994;12(2):1–24. PMID: 7728157.
  2. Kazem M, Hutcheon JA, Joseph KS. A population-based study of antenatal corticosteroid prophylaxis for preterm birth. J Obstet Gynaecol Can 2012;34(9):842–848. DOI: 10.1016/S1701-2163(16)35383-X.
  3. Ha Y, Lee KH, Jung S, et al. Glucocorticoid-induced diabetes mellitus in patients with systemic lupus erythematosus treated with high-dose glucocorticoid therapy. Lupus 2011;20(10):1027–1034. DOI: 10.1177/0961203311402246.
  4. Yildirim Y, Tinar S, Oner RS, et al. Gestational diabetes mellitus in patients receiving long-term corticosteroid therapy during pregnancy. J Perinat Med 2006;34(4):280–284. DOI: 10.1515/JPM.2006.053.
  5. Tappy L, Randin D, Vollenwieder P. Mechanisms of dexamethasone-induced insulin resistance in healthy humans. J Clin Endocrinol Metab 1994;79(4):1063–1069. DOI: 10.1210/jcem.79.4.7962275.
  6. Miracle X, Di Renzo GC, Stark A, et al. Coordinators of World Association of Perinatal Medicine Prematurity Working Group. Guideline for the use of antenatal corticosteroids for fetal maturation. J Perinat Med 2008;36(3):191–196. DOI: 10.1515/JPM.2008.032.
  7. Bajwa SS, Baruah MP, Kalra S, et al. Guidelines on inpatient management of hyperglycemia. In: Muruganathan A, editor. Medicine update. vol. 23. Association of Physicians of India; 2013. p. 164–169.
  8. Diabetes in pregnancy: Management of diabetes and its complications from pre-conception to the postnatal period. London: NICE; 2008. [Accessed August 4, 2013]. National Institute for Health and Clinical Excellence. Available from: http://www.nice.org.uk/nicemedia/pdf/CG63NICEGuidelineReissue.pdf.
  9. Mathiesen ER, Christensen AB, Hellmuth E, et al. Insulin dose during glucocorticoid treatment for fetal lung maturation in diabetic pregnancy: test of an algorithm. Acta Obstet Gynecol Scand 2002;81(9):835–839. DOI: 10.1034/j.1600-0412.2002.810906.x.
  10. Melamed N, Chen R, Soiberman U, et al. Spontaneous and indicated preterm delivery in pregestational diabetes mellitus: etiology and risk factors. Arch Gynecol Obstet 2008;278(2):129–134. DOI: 10.1007/s00404-007-0541-z.
  11. Renuka S, Sreevalsan A, Sathiya S, et al. To evaluate changes in blood glucose following antenatal corticosteroid therapy in preterm antenatal women of gestational age 28-34 weeks. J Evolut Med Dent Sci 2014;3(21):5727–5733. DOI: 10.14260/jemds/2014/2656.
  12. Beena B, Libu GK, Akhila MS, et al. The effect of antenatal corticosteroids on maternal glycemic control, in a tertiary care centre in North Kerala-India. Int J Reprod Contracept Obstet Gynecol 2019;8:4668–4673. DOI: 10.18203/2320-1770.ijrcog20195189.
  13. Kreiner A, Gil K, Lavin J. The effect of antenatal corticosteroids on maternal serum glucose in women with diabetes. Open J Obstet Gynecol 2012;2:112–115. DOI: 10.4236/ojog.2012.22021.
  14. Ramírez-Torres MA, Pérez-Monter SE, Espino y Sosa S, et al. Effect of betamethasone in blood glucose levels in pregnant diabetic women at risk of preterm birth. Ginecol Obstet Mex 2011;79(9):565–571. PMID: 21966858.
  15. Foglia L, Deering S, Lim E, et al. Maternal glucose levels after dexamethasone for fetal lung development in twin vs singleton pregnancies. Am J Obstet Gynecol 2008;199(4):380–381. DOI: 10.1016/j.ajog.2008.08.004.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.