Oral Corticosteroids and Risk of Preterm Birth in the California Medicaid Program
| العنوان: | Oral Corticosteroids and Risk of Preterm Birth in the California Medicaid Program |
|---|---|
| المؤلفون: | Gretchen Bandoli, Gabriela Vazquez-Benitez, Christina D. Chambers, Jim Watkins, Kristin Palmsten, Todd Gilmer |
| المصدر: | J Allergy Clin Immunol Pract The journal of allergy and clinical immunology. In practice, vol 9, iss 1 |
| سنة النشر: | 2020 |
| مصطلحات موضوعية: | Reproductive health and childbirth, Low Birth Weight and Health of the Newborn, Inflammatory bowel disease, California, 0302 clinical medicine, Prednisone, Adrenal Cortex Hormones, Pregnancy, Risk Factors, Oral corticosteroids, Infant Mortality, Immunology and Allergy, Medicine, 030212 general & internal medicine, Lung, Pediatric, Obstetrics, Cumulative dose, Hazard ratio, Antirheumatic agents, Respiratory, Gestation, Adrenergic β(2) receptor agonists, Premature Birth, Female, Leukotriene antagonist, medicine.drug, medicine.medical_specialty, Lupus, Adrenergic beta(2) receptor agonists, Article, 03 medical and health sciences, Systemic lupus erythematosus, Preterm, Clinical Research, Humans, Glucocorticoids, Asthma, business.industry, Medicaid, Prevention, Infant, Newborn, Infant, Preterm birth, Perinatal Period - Conditions Originating in Perinatal Period, medicine.disease, Newborn, Confidence interval, 030228 respiratory system, Relative risk, business |
| الوصف: | Background There is limited information regarding the impact of dose and gestational timing of oral corticosteroid (OCS) use on preterm birth (PTB), especially among women with asthma. Objectives To evaluate OCS dose and timing on PTB for asthma and, as a comparison, systemic lupus erythematosus (SLE). Methods We used health care data from California Medicaid enrollees linked to birth certificates (2007-2013), identifying women with asthma (n = 22,084) and SLE (n = 1174). We estimated risk ratios (RR) for OCS cumulative dose trajectories and other disease-related medications before gestational day 140 and hazard ratios (HR) for time-varying exposures after day 139. Results For asthma, PTB risk was 14.0% for no OCS exposure and 14.3%, 16.8%, 20.5%, and 32.7% in low, medium, medium-high, and high cumulative dose trajectory groups, respectively, during the first 139 days. The high-dose group remained associated with PTB after adjustment (adjusted RR [aRR]: 1.46; 95% confidence interval [CI]: 1.00, 2.15). OCS dose after day 139 was not clearly associated with PTB, nor were controller medications. For SLE, PTB risk for no OCS exposure was 24.9%, and it was 39.1% in low- and 61.2% in high-dose trajectory groups. aRR were 1.80 (95% CI: 1.34, 2.40) for high and 1.24 (95% CI: 0.97, 1.58) for low groups. Only prednisone equivalent dose >20 mg/day after day 139 was associated with increased PTB (adjusted HR: 2.54; 95% CI: 1.60, 4.03). Conclusions For asthma, higher OCS doses early in pregnancy, but not later, were associated with increased PTB. For SLE, higher doses early and later in pregnancy were associated with PTB. |
| وصف الملف: | application/pdf |
| اللغة: | English |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::f18c854e4c47c947985d066e82ccb9f9 https://europepmc.org/articles/PMC7805577/ |
| Rights: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....f18c854e4c47c947985d066e82ccb9f9 |
| قاعدة البيانات: | OpenAIRE |
| الوصف غير متاح. |