EFFECT OF ANTENATAL CORTICOSTEROIDS ON MATERNAL BLOOD GLUCOSE LEVELS

Main Article Content

Rukhsana Karim
Rubina Akhtar
Sadia Ali
Shamshad Begum

Abstract

Objective: To study the effect of antenatal corticosteroids on maternal blood glucose levels.
Methodology: This observational study was conducted in the Department of Obstetrics and Gynecology at Hayatabad Medical Complex, Peshawar, after obtaining ethical approval from the Institutional Ethical Review Board. All patients admitted to the labor suite for antenatal corticosteroids were included in the study, while patients with diabetes or any other medical disorder requiring corticosteroids were excluded. Patients were selected using a non-probability convenient sampling technique. They were given two doses of Betamethasone (12mg) intramuscularly, with a 24-hour interval between doses. Maternal blood sugar levels were checked before administering the first dose of Betamethasone. Subsequently, patients were placed on a sugar profile for five days. All the data were entered in a pre-designed proforma.


Results: A total of 247 patients were included in the study. The majority of the patients were multigravida (50.20%) and belonged to the age group of 21-30 (50.20%). The mean age of the patients was 26.4 ± 2.3 years. The majority of the patients (72.46%) had deranged blood sugar levels, either falling within the range of impaired glucose levels or full-blown diabetes. Antenatal corticosteroids mainly affected fasting blood sugar (FBS) and post-prandial blood sugar levels.
Conclusion: Antenatal corticosteroids administered to normoglycemic patients result in significant but transient hyperglycemia. However, in the majority of patients, blood sugar levels normalize within five days following the administration of corticosteroid doses.

Article Details

How to Cite
1.
Karim R, Akhtar R, Sadia Ali, Shamshad Begum. EFFECT OF ANTENATAL CORTICOSTEROIDS ON MATERNAL BLOOD GLUCOSE LEVELS. J Postgrad Med Inst [Internet]. 2023 Aug. 27 [cited 2024 Nov. 22];37(3):181-5. Available from: https://jpmi.org.pk/index.php/jpmi/article/view/3224
Section
Original Article
Author Biography

Rubina Akhtar, Department of Obstetrics and Gynaecology Hayatabad Medical Complex, Peshawar.

Department of Obstetrics and Gynaecology Hayatabad Medical Complex, Peshawar.

References

- Tamez-Perez HE, Quintanilla-Flores DL, Rodríguez-Gutiérrez R, González-González JG, Tamez-Peña AL. Steroid hyperglycemia: Prevalence, early detection and therapeutic recommendations: A narrative review. World J Diabetes 2015;6(8):1073-81. DOI: 10.4239/wjd.v6.i8.1073.

- Tappy L, Randin D, Vollenwieder P. Mechanisms of dexamethasone induced insulin resistance in healthy humans. J Clin Endocrinol Metab. 1994;79(4):1063–9. DOI: 10.1210/jcem.79.4.7962275.

- Bonaventura A, Montecucco F. Steroid-induced hyperglycemia: An underdiagnosed problem or clinical inertia? A narrative review. Diabetes Res Clin Pract. 2018;139:203-20. DOI: 10.1016/j.diabres.2018.03.006.

- Beksac MS, Korkmaz A, Kasapoglu T, Ozdemir P, Cosgun E, Tanacan A. Antenatal corticosteroids for women at risk of preterm delivery: the "Emperor's New Clothes" tale in medical practice. J Matern Fetal Neonatal Med. 2022;35(4):705-12. DOI: 10.1080/14767058.2020.1731455.

- McGoldrick E, Stewart F, Parker R, Dalziel SR. Antenatal corticosteroids for accelerating fetal lung maturation for women at risk of preterm birth. Cochrane Database Syst Rev. 2020;12(12):CD004454. DOI: 10.1002/14651858.CD004454.pub4.

- Samouilidis A, Beltsios ET, Mavrovounis G, Adamou A, Belios I, Hadjivasilis A, Pantazopoulos I, Agouridis AP. The Use of Antenatal Dexamethasone in Late Preterm and Term Pregnancies to Improve Neonatal Morbidity and Mortality: A Systematic Review and Meta-Analysis. Cureus. 2022;14(8):e27865. DOI: 10.7759/cureus.27865.

- Committee on Obstetric Practice. Committee Opinion No. 713: Antenatal Corticosteroid Therapy for Fetal Maturation. Obstet Gynecol 2017;130(2):e102-9. DOI: 10.1097/AOG.0000000000002237.

- National Institue for Health and Care Excellence. Preterm labour and birth. NICE guideline NG25. London: NICE; 2015. updated 2019.

- Royal College of Obstetricians and Gynaecologists. Antenatal corticosteroids to reduce neonatal morbidity and mortality. RCOG Green-top Guideline no. 74. London: RCOG; 2022.

- Janssen O, Ratner V, Lin J, Fox N, Green R. Respiratory and glycemic control outcomes of late preterm infants after antenatal corticosteroid exposure. J Perinatol. 2021;41(11):2607-13. DOI: 10.1038/s41372-021-01162-y.

- Dashora U, Levy N, Dhatariya K, Willer N, Castro E, Murphy HR; Joint British Diabetes Societies in Patient group. Managing hyperglycaemia during antenatal steroid administration, labour and birth in pregnant women with diabetes - an updated guideline from the Joint British Diabetes Society for Inpatient Care. Diabet Med. 2022;39(2):e14744. DOI: 10.1111/dme.14744.

- Yamamoto JM, Benham J, Mohammad K, Donovan LE, Wood S. Intrapartum glycaemic control and neonatal hypoglycaemia in pregnancies complicated by diabetes: a systematic review. Diabet Med. 2018;35(2):173-183. DOI: 10.1111/dme.13546

- Renuka S, Sreevalsan A, Sathiya S, Vasantha N. Subbiah . 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):5727–33. DOI: 10.14260/jemds/2014/ 2656.

- Beena B, Libu GK, Akhila MS, Chandran J. 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(12):4668–73. DOI: 10.18203/2320-1770.ijrcog20195189.

- Naheed S, Asghar S, Dureshahwar, Gul S, Jamil M, Akram A. Transient Hyperglycemia and Gestational Diabetes Mellitus in Preterm Pregnant Women after Receiving Antenatal Steroids. J Islamabad Med Dental Coll. 2021; 10(4):206-9.

- 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 Obst Gynae. 2022;14(2):148–51.

- Chaurasia A, Singh V. Effect of Antenatal Betamethasone and Dexamethasone on Maternal Blood Glucose Levels, Fetal Movement, Nst Parameters, and Umbilical Artery Doppler. J Matern Child Health. 2022; 07(03): 316-25.

- Kakoulidis I, Ilias I, Linardi A, Michou A, Milionis C, Petychaki F, et al. Glycemia after Betamethasone in Pregnant Women without Diabetes-Impact of Marginal Values in the 75-g OGTT. Healthcare. 2020;8(1):40. DOI: 10.3390/healthcare8010040.

- Tuohy JF, Bloomfield FH, Crowther CA, Harding JE. Maternal and neonatal glycaemic control after antenatal corticosteroid administration in women with diabetes in pregnancy: A retrospective cohort study. PLoS One. 2021;16(2):e0246175. DOI: 10.1371/journal.pone.0246175.

- Kalra S, Kalra B, Gupta Y. Glycemic management after antenatal corticosteroid therapy. N Am J Med Sci. 2014;6(2):71-6. DOI: 10.4103/1947-2714.127744.

- Jolley JA, Rajan PV, Petersen R, Fong A, Wing DA. Effect of antenatal betamethasone on blood glucose levels in women with and without diabetes. Diabetes Res Clin Pract. 2016;118:98-104. DOI: 10.1016/j.diabres.2016.06.005.