Pregnant women who use inhaled glucocorticoids to relieve breathlessness that occurs randomly with asthma may be increasing their child’s chances of developing endocrine or metabolic disorders, according to a new study published in the American Journal of Respiratory and Critical Care Medicine.
The study was based on a review of 65,085 mother-child pairs from the Danish National Birth Cohort. Researchers found that children who were exposed to glucocorticoids in utero were nearly 80 percent more likely to develop some type of endocrine or metabolic disorder by the age of 6. The risk was dependent on the frequency of use of the inhaled asthma treatment.
Endocrine disorders involve the body’s over- or under-production of hormones, while metabolic disorders affect the body’s ability to process certain nutrients and vitamins. Endocrine disorders include hypothyroidism, congenital adrenal hyperplasia, diseases of the parathyroid gland, diabetes mellitus, diseases of the adrenal glands (including Cushing’s syndrome and Addison’s disease), and ovarian dysfunction (including polycystic ovary syndrome). Examples of metabolic disorders include cystic fibrosis, phenylketonuria (PKU), hyperlipidemia, gout, and rickets.
Inhaled glucocorticoids are among the most common treatments for asthma symptoms, and are the preferred treatment of asthma during pregnancy. The treatment has not previously been associated with pregnancy complications, obstetric outcomes, and offspring malformations. The new study, however, suggests that the long-term consequences of inhaled glucocorticoids during pregnancy should be considered further. Other asthma treatment options are available that have not shown to have adverse affects on developing fetuses.