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Antenatal Corticosteroids Increases the Need for Insulin in Non-Diabetic Patients Based on BMI [1P]

INTRODUCTION: The administration of antenatal corticosteroids is widely used in obstetrics for patients at risk for preterm delivery from 24–34 weeks gestation. A commonly recognized side effect from administration is maternal hyperglycemia. In women that have gestational or pregestational diabetes betamethasone can lead to severe hyperglycemia and rarely DKA. Obese women are known to be at increased risk for glucose intolerance during pregnancy. The effect of betamethasone on blood sugar levels in non-diabetic but obese women is unknown. METHODS: At Albany Medical Center, following steroid administration, glucose monitoring is routine in the high-risk patients. We conducted a retrospective study of all patients admitted from 1/1/2013–7/15/2015 that received a single course of antenatal corticosteroids at less than 34 weeks gestation. Patients were stratified according to the BMI at the time of administration. Of the 692 non-diabetic patients that received antenatal corticosteroids, 216 patients were categorized as being at high risk for glucose intolerance and were followed closely with fingerstick evaluations. RESULTS: In patients with class 1 obesity we did not identify any evidence of glucose intolerance requiring treatment. Similarly in patients with class 2 obesity none of the patients required medical management for hyperglycemia. However 5% of women with class 3 obesity required treatment with insulin but the treatment lasted less than 48 hours. CONCLUSION: Betamethasone can cause hyperglycemia in the non-diabetic obese patient. Non-diabetic women with class 3 obesity are at risk of hyperglycemia requiring insulin following betamethasone administration for fetal lung maturation.