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Exposure to Topical Retinoids in First Trimester Not Associated with Adverse Pregnancy Outcomes

Topical retinoids are a popular acne treatment and minimal systemic absorption implies they are a safer choice than systemic retinoids for women of reproductive age. However, there were concerns that topical retinoids may be associated with major congenital malformations stemming from reports received by the FDA in the late 1980s. Although the proposed association between topical retinoid exposure during pregnancy and major congenital malformations was never demonstrated in case series or observational cohorts, the concern was that a rare association may still exist.

In a recent study published in British Journal of Dermatology, researchers sought to determine whether prenatal exposure to topical retinoids is associated with adverse pregnancy outcomes and to increase the power of evidence by performing a meta-analysis of all available studies. Authors specifically looked at the rates of major congenital malformations, spontaneous abortion, stillbirth, elective termination of pregnancy, low birth weight and prematurity. The meta-analysis included a total of 654 pregnant women who were exposed to topical retinoids and 1375 unexposed control pregnant women. The systematic review and analysis finds that first trimester exposure to topical retinoids does not cause a major increase in the rates of major congenital malformations, spontaneous abortions, low birth weight, and prematurity. However, due to a lack of detailed information in the studies the authors could not evaluate the dose of the exposed topical retinoid.

The authors caution that despite the lack of association, “the results of our study may be primarily used to reassure pregnant women who are inadvertently exposed to topical retinoids during their pregnancy…the relatively small sample size does not allow support of the use of topical retinoids during pregnancy.”

By: Wendy Meltzer, MPH


Adapted from the original article.

[image by Jan vd Brink]

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