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Are Topical Corticosteroids Safe in Pregnancy?

When pregnant patients need treatment, healthcare providers want to ensure that the treatments they choose carry the least risk. Previous animal studies suggested that the use of topical corticosteroids may lead to low birth weight; however, the safety of topical corticosteroids in human pregnancy was not clear. A Cochrane review was performed to assess whether maternal use of topical corticosteroids affect specific pregnancy outcomes. The authors reviewed 14 studies conducted over 17 years. They compared primary and secondary outcomes for women who used topical corticosteroids at all versus those who did not, and then further compared the potency of the corticosteroids and the associated outcomes against the control group. The patients studied were largely Caucasian, ranging in age from 15-42 years old. The primary outcomes were mode of delivery, major birth defects, low birth weight, and preterm delivery. Secondary outcomes included fetal death, mild birth defects, and low Apgar score. After reviewing data that encompassed over 1.6 million patients, the authors concluded that the available evidence found no associations of maternal use of topical corticosteroids of any potency with mode of delivery, birth defects, preterm delivery, fetal death, and low Apgar score. However, low birth weight was associated with maternal use of potent or very potent topical corticosteroids, especially when the administered dosage during pregnancy is large.

The authors note that mild or moderately potent topical corticosteroids should be preferred when corticosteroid use is indicated during a pregnancy.

 

Byline: Martha L. Sikes, MS, RPh, PA-C

Posted: September 19, 2016

Source: Cochrane Library
Adapted from the original article.

[Image: Pixabay / PedroSerapio]