Dataset Information

Use of inhaled corticosteroids during pregnancy and risk of pregnancy induced hypertension: nested case-control study.

ABSTRACT:

Objective

To determine whether the use of inhaled corticosteroids during pregnancy increases the risk of pregnancy induced hypertension and pre-eclampsia among asthmatic women.

Design

Nested case-control study.

Setting

Three administrative health databases from Quebec: RAMQ, MED-ECHO, and Fichier des evenements demographiques.

Participants

3505 women with asthma, totalling 4593 pregnancies, between 1990 and 2000.

Main outcome measures

Pregnancy induced hypertension and pre-eclampsia.

Results

302 cases of pregnancy induced hypertension and 165 cases of pre-eclampsia were identified. Use of inhaled corticosteroids from conception until date of outcome was not associated with an increased risk of pregnancy induced hypertension (adjusted odds ratio 1.02, 95% confidence interval 0.77 to 1.34) or pre-eclampsia (1.06, 0.74 to 1.53). No significant dose-response relation was observed between inhaled corticosteroids and pregnancy induced hypertension or pre-eclampsia. Oral corticosteroids were significantly associated with the risk of pregnancy induced hypertension (adjusted odds ratio 1.57, 1.02 to 2.41), and a trend was seen for pre-eclampsia (1.72, 0.98 to 3.02).

Conclusion

No significant increase of the risk of pregnancy induced hypertension or pre-eclampsia was detected among users of inhaled corticosteroids during pregnancy, while markers of uncontrolled and severe asthma were found to significantly increase the risks of pregnancy induced hypertension and pre-eclampsia.

SUBMITTER: Martel MJ

PROVIDER: S-EPMC546071 | biostudies-literature | 2005 Jan

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Use of inhaled corticosteroids during pregnancy and risk of pregnancy induced hypertension: nested case-control study.

Martel Marie-Josée MJ Rey Evelyne E Beauchesne Marie-France MF Perreault Sylvie S Lefebvre Geneviève G Forget Amélie A Blais Lucie L

BMJ (Clinical research ed.) 20050119 7485

<h4>Objective</h4>To determine whether the use of inhaled corticosteroids during pregnancy increases the risk of pregnancy induced hypertension and pre-eclampsia among asthmatic women.<h4>Design</h4>Nested case-control study.<h4>Setting</h4>Three administrative health databases from Quebec: RAMQ, MED-ECHO, and Fichier des evenements demographiques.<h4>Participants</h4>3505 women with asthma, totalling 4593 pregnancies, between 1990 and 2000.<h4>Main outcome measures</h4>Pregnancy induced hyperte ...[more]

PMID: 15659480

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Project description:BackgroundAlthough certain opioid analgesics have immunosuppressive properties and increase the risk for infections in animals, the clinical effects of prescription opioid use on infection risk among humans are unknown.ObjectiveTo test the hypothesis that prescription opioid use is an independent risk factor for invasive pneumococcal disease (IPD).DesignNested case-control study.SettingTennessee Medicaid database linked to Medicare and Active Bacterial Core surveillance system databases (1995 to 2014).Patients1233 case patients with IPD aged 5 years and older matched to 24 399 control participants by diagnosis date, age, and county of residence.MeasurementsOpioid use was measured on the basis of pharmacy prescription fills. Invasive pneumococcal disease was defined by the isolation of Streptococcus pneumoniae from a normally sterile site. The odds of current opioid use were compared between the case and control groups, accounting for known IPD risk factors. Secondary analyses categorized opioid use by opioid characteristics, applied an IPD risk score to assure comparability between exposure groups, and analyzed pneumonia and nonpneumonia IPD cases separately.ResultsPersons in the case group had greater odds than control participants of being current opioid users (adjusted odds ratio [aOR], 1.62 [95% CI, 1.36 to 1.92]). Associations were strongest for opioids that were long acting (aOR, 1.87 [CI, 1.24 to 2.82]), of high potency (aOR, 1.72 [CI, 1.32 to 2.25]), or were used at high dosages (50 to 90 morphine milligram equivalents [MME]/d: aOR, 1.71 [CI, 1.22 to 2.39]; ≥90 MME/d: aOR, 1.75 [CI, 1.33 to 2.29]). Results were consistent when the IPD risk score was taken into account and pneumonia and nonpneumonia IPD were analyzed separately.LimitationsUnmeasured confounding and measurement error, although sensitivity analyses suggested that neither was likely to affect results. Actual opioid use and other nonprescription use (such as illicit opioid use) were not measured.ConclusionOpioid use is associated with an increased risk for IPD and represents a novel risk factor for these diseases.Primary funding sourceNational Institutes of Health.

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Dataset Information

Use of inhaled corticosteroids during pregnancy and risk of pregnancy induced hypertension: nested case-control study.

Objective

Design

Setting

Participants

Main outcome measures

Results

Conclusion

Publications

Use of inhaled corticosteroids during pregnancy and risk of pregnancy induced hypertension: nested case-control study.

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