Effect of low dose prednisone on glucose metabolism levels in patients with spontaneous abortion: A single-center, prospective cohort study

In this single-center, prospective cohort study, we aimed to explore the effect of low dose prednisone treatment during pregnancy on blood glucose levels in patients with spontaneous abortion. Patients with a history of spontaneous abortion were enrolled and were assigned to two groups according to whether they were exposed to low dose prednisone during pregnancy. All patients received OGTT at early and late pregnancy. Fasting serum C-peptide and HbA1c levels were measured at the same time. We then analyzed the incidence of DM, impaired fasting glucose, impaired glucose tolerance and the incidence of GDM. A total of 355 patients were enrolled. No significant difference in OGTT between the two groups were observed in the first trimester (P=0.142). However, patients in the prednisone group showed a significant increase in fasting serum C-peptide (P<0.001). Regarding late pregnancy, patients in the prednisone group showed a significant increase in 2-h plasma glucose (P=0.010). Patients in the prednisone group also had a higher incidence of GDM (P=0.005). Furthermore, family history of DM and receiving low dose prednisone were significantly associated with higher risk of gestational glycometabolism abnormality in patients with spontaneous abortion. Therefore, our study suggested that long-term exposure of low dose prednisone during pregnancy could impair postprandial blood glucose and increase the incidence of GDM. Routine monitor of blood glucose and C-peptide levels should be recommended in patients who received prednisone treatment during pregnancy.