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BACKGROUND

At least 6 per cent of pregnant women use topical corticosteroids. However, in animals topical corticosteroids are teratogenic and restrict foetal growth. In humans, topical steroids' safety in pregnancy €is not fully understood€.

METHOD

A retrospective study of 2,658 pregnant women in the UK using topical corticosteroids and 7,246 unexposed pregnant women.

RESULTS

Maternal use of topical corticosteroids was not associated with orofacial cleft, low birth weight, pre-term delivery, foetal death, low Apgar score and delivery method (e.g. caesarean). Stratifying analyses based on steroid potency (mild to very potent) did not reveal any significant associations for most outcomes. However, the risk of low birth weight was almost eight times higher (adjusted relative risk 7.74) when women used more than 300g of potent or very potent topical corticosteroids during pregnancy compared to controls.

CONCLUSIONS

This study €reassuringly€ showed no associations between maternal topical corticosteroid exposure and orofacial cleft, pre-term delivery, foetal death, low Apgar score and delivery method. However this study and previous evidence suggests that the risk of low birth weight correlates with the quantity of strong topical corticosteroid used during pregnancy.

Therefore, the authors suggest, pregnant women with skin conditions should preferentially use mild or moderate topical corticosteroids. €When potent or very potent topical corticosteroids are needed, the amounts used should be kept to a minimum and [foetal] growth should be monitored,€ they comment.

REFERENCE

Chi C-C, Wang S-H, Mayon-White R, Wojnarowska F. Pregnancy outcomes after maternal exposure to topical corticosteroids: A UK population-based cohort study. JAMA Dermatol 2013; 149 (11):1274-1280