Yildirim Yusuf, Tinar Sivekar, Oner Recai Soner, Kaya Baris, Toz Emrah
Aegean Obstetrics and Gynecology Training and Research Hospital, Department of Obstetrics and Gynecology, Yenisehir, Izmir, Turkey.
J Perinat Med. 2006;34(4):280-4. doi: 10.1515/JPM.2006.053.
Little data exist on the impact of chronic low dose corticosteroid therapy during pregnancy on gestational diabetes mellitus (GDM).
We compared 25 pregnant women receiving long-term (>4 weeks) corticosteroid for newly diagnosed idiopathic thrombocytopenic purpura (ITP) (study group) and 108 normal pregnant women (control group) in this case-control study. Main outcome measures were 1-h, 50-g and 3-h, 100-g glucose tolerance tests (GTTs). Women in both groups were also screened with 75-g GTT 6 weeks after delivery.
The mean duration of corticosteroid therapy was 9.8+/-4.9 (range 6-25) weeks. Compared with controls, study group patients had a greater prevalence of diagnosed GDM (24.0 vs. 2.8%, P=0.01). Of these patients, 83.3% were diagnosed with GDM at 16 weeks gestation. An impaired 75-g GTT was also more frequent in the study group (P=0.01).
Our findings suggest that long-term corticosteroid therapy may be associated with the development of diabetes in pregnant women and early GTT should be performed in pregnant women on corticosteroid therapy.
关于孕期慢性低剂量皮质类固醇激素治疗对妊娠期糖尿病（GDM）影响的数据较少。
在这项病例对照研究中，我们比较了25名因新诊断的特发性血小板减少性紫癜（ITP）接受长期（>4周）皮质类固醇激素治疗的孕妇（研究组）和108名正常孕妇（对照组）。主要观察指标为1小时、50克和3小时、100克葡萄糖耐量试验（GTT）。两组女性在分娩后6周也进行了75克GTT筛查。
皮质类固醇激素治疗的平均持续时间为9.8±4.9（范围6 - 25）周。与对照组相比，研究组患者确诊GDM的患病率更高（24.0%对2.8%，P = 0.01）。在这些患者中，83.3%在妊娠16周时被诊断为GDM。研究组中75克GTT受损的情况也更常见（P = 0.01）。
我们的研究结果表明，长期皮质类固醇激素治疗可能与孕妇患糖尿病有关，接受皮质类固醇激素治疗的孕妇应尽早进行GTT检查。
