Low birth weight not associated with topical corticosteroid use in pregnancy

The use of topical corticosteroids during pregnancy was not associated with low birth weight, according to a study.

“The prevalence of topical corticosteroid use during pregnancy is reported to be as high as 7%,” Niklas Worm Andersson, MD, of the department of epidemiology research at Statens Serum Institut, the department of clinical pharmacology at Copenhagen University Hospital Bispebjerg and Frederiksberg, and the department of allergy and dermatology at Gentofte and Herlev Hospital, and colleagues wrote. “Data to help evaluate potential fetal harm from topical corticosteroid use in pregnancy are limited and conflicting.”

A nationwide cohort study used the Danish Medical Birth Registry to identify 60,497 corticosteroid-exposed pregnancies matched with 241,986 unexposed pregnancies over a 20-year period.

Of those who were exposed to corticosteroids, 5,678 (9%) had an infant who was born small for gestational age compared with 22,634 (9.4%) of unexposed pregnancies (RR = 1.00; 95% CI, 0.98-1.03; ARD = 0.3; 95% CI, 2.3 to 2.9 per 1,000 pregnancies). Low birth weight occurred in 2,006 (3.3%) exposed pregnancies and 8,675 (3.6%) unexposed pregnancies (RR = 0.92; 95% CI, 0.88-0.97; ARD = –2.7; 95% CI, –4.3 to –1.1 per 1,000 pregnancies).

Of 27,630 pregnancies exposed to potent or very potent topical steroids, small for gestational age occurred in 2,662 births (9.6%), with low birth weight occurring in 928 (3.4%).

“These findings suggest that topical corticosteroids, including potent to very potent agents, in large amounts can be used in pregnancy without increased concerns of [small for gestational age] and low birth weight,” the authors wrote.