Risk of miscarriage among users of corticosteroid hormones: a population-based nested case-control study

Abstract

Background

The purpose of this nested case-control study in Denmark was to study the association between use of corticosteroids and risk of miscarriage.

Methods

We identified prescriptions for corticosteroids before the miscarriage/index date. We estimated odds ratios (ORs) for miscarriage and for early (<13 weeks) and late (13–21 weeks) miscarriage adjusting for age, history of diabetes and epilepsy, and nonsteroidal anti-inflammatory drug use.

Results

We identified 10,974 women with miscarriage and 109,740 controls. Prevalence of inhaled corticosteroid use within 60 days before the index date was 1.3% among the cases and 1.0% among the controls (OR = 1.20; 95% confidence interval [CI] 1.01–1.44). Prevalence of oral corticosteroid use within 60 days before the index date was 0.3% for both cases and controls (OR = 0.78; 95% CI 0.53–1.15). For inhaled and oral corticosteroids, the ORs of early miscarriage were 1.22 (95% CI 1.01–1.49) and 0.81 (95% CI 0.55–1.20), respectively.

Conclusion

Use of inhaled corticosteroids was associated with a slightly increased risk of early miscarriage, but explanations alternative to causal ones were possible.

Keywords:

• case-control study
• corticosteroid hormones
• epidemiology
• miscarriage

Supplementary material

Supplementary Table 1 Codes from the International Classification of Diseases (ICD) and Anatomical Therapeutic Chemical (ATC) classification used to identify diagnoses from the Danish National Registry of Patients and to identify dispensing of prescribed drugs from the Aarhus University Prescription Database

Acknowledgments

This work was supported in part by grants from the Augustinus Foundation, the Foundation of Dagmar Marshalls, the Foundation of the Faculty of Health in the Central Region of Denmark, the Foundation of Sophus Jacobsen and Astrid Jacobsen, the Department of Clinical Epidemiology Research, and Aarhus University.

Disclosure

The authors report no conflicts of interest in this work.