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Most pregnancy outcomes unaffected by topical corticosteroids

Use of topical corticosteroids during pregnancy was not significantly associated with many adverse effects at birth, although low birth weight appeared to correlate with greater exposure to potent topical corticosteroids, according to recent study results.

“Topical corticosteroids are … prescribed to more than 6% of pregnant women, but their safety in pregnancy is not fully understood,” the researchers reported.

Researchers used data from the United Kingdom National Health Service from 1989 to 2006 for the retrospective cohort study. They enrolled 2,658 pregnant women, aged 15 to 44 years, who had received one or more prescriptions for topical corticosteroids during pregnancy (exposed group) and 7,246 pregnant women of the same age group who did not receive corticosteroid prescriptions (unexposed group). Orofacial cleft, low birth weight (LBW; birth weight <2,500 g), preterm delivery (before 37 completed weeks’ gestation), fetal death, low Apgar score (<7 at 5 minutes) and mode of delivery were the main outcomes.

Primary analysis found no significant associations between topical corticosteroid exposure and orofacial cleft (adjusted RR=1.85; 95% CI, 0.22-15.20), LBW (aRR=0.97; 95% CI, 0.78-1.19), preterm delivery (aRR=1.20; 95% CI, 0.73-1.96), fetal death (aRR=1.07; 95% CI, 0.56-2.05), low Apgar score (aRR=0.84; 95% CI, 0.54-1.31) or delivery method (P=.76).

No significant associations were found using stratified analyses based on corticosteroid potency. When the dispensed amount of potent or very potent topical corticosteroids exceeded 300 g during the pregnancy, however, exploratory analysis displayed a significant increased risk for LBW (aRR=7.74; 95% CI, 1.49-40.11).

“For pregnant women with a skin condition, mild or moderate topical corticosteroids are the preferred treatments if indicated,” the researchers concluded. “When potent or very potent topical corticosteroids are needed, the amounts used should be kept to a minimum, and fetal growth should be monitored.”

Disclosure: The researchers report no relevant financial disclosures.