For women with autoimmune conditions, taking high doses of steroids during pregnancy may increase their risk of serious infection, according to the findings of new research.
In a study published last week in the medical journal The BMJ, researchers with Harvard Medical School and Brigham and Women’s Hospital found that pregnant women faced a similar risk of infection when taking different types of immunosuppressive drugs; but the risk of infection was especially high when taking high dose steroids.
Researchers analyzed data involving nearly 5,000 pregnant women between the ages of 12 and 55, who had both public and private health insurance programs in the U.S. The pregnant women were treated with various types of immunosuppressive drugs for autoimmune conditions, including rheumatoid arthritis, systemic lupus erythematous, ankylosing spondylitis, psoriatic arthritis or inflammatory bowel disease.
Women were given either systemic steroids, non-biologic agents or tumor necrosis factor inhibitors (TNF). Their first filled prescription had to have occurred during pregnancy to be included in the study.
Roughly 71 of the 5,000 pregnant women who were treated with immunosuppressive drugs experienced serious infections.
Each drug was associated with similar levels of infection risk for the pregnant women. However, a higher infection risk was noted with high doses of steroids. High doses increased the infection risk during pregnancy significantly, the researchers concluded.
Autoimmune inflammatory conditions affect approximately 3 to 4 million Americans and the conditions are known to predominantly affect females. It can especially affect women in early child bearing years. They are often treated with steroids, however the risk of infection is a major concern with steroid use because they are known to interfere with a patient’s immune system.
Pregnancy infections put a woman at increased risk of other adverse neonatal outcomes, including an increased risk of preterm births, intrauterine growth restriction, and spontaneous abortions.
“Risk of serious infections is similar among pregnant women with systemic inflammatory conditions using steroids, non-biologics, and TNF inhibitors,” wrote study authors. “However, high dose steroid use is an independent risk factor of serious infections in pregnancy.”
Researchers warn pregnant patients with autoimmune conditions that they should be carefully monitored by doctors when taking steroids and other immunosuppressive drugs.