Topical Corticosteroids in Pregnancy Have No Impact on Birth Weight

By David Douglas

May 14, 2021

NEW YORK (Reuters Health) - Use of topical corticosteroids does not appear to increase the risk of newborns being small for gestational age or having low birth weight, according to a large cohort study from Denmark.

"Findings from some previous fetal-safety studies on topical corticosteroid use in pregnancy have raised concerns for an increased risk of newborns being small for gestational age (SGA) or having low birth weight, in particular among pregnancies where larger amounts of potent to very potent agents have been used," Dr. Niklas Worm Andersson of Statens Serum Institut, in Copenhagen, explained in an email to Reuters Health.

Dr. Andersson and his colleagues examined Danish Medical Birth Registry data covering more than 11 million pregnancies between 1997 and 2016.

The team identified more than 60,000 corticosteroid-exposed pregnancies and matched them with 260,000 pregnancies without such exposure. SGA was seen in 9.4% of infants who were not exposed and 9.4% of those who were exposed, the team reports in JAMA Dermatology.

Similarly, low birth weight was seen in 3.3% of the exposed pregnancies compared with 3.6% of the unexposed pregnancies. Exposure to potent to very potent topical corticosteroids of any amount was not associated with an increased risk of these conditions.

A post hoc analysis comparing those who had received doses of 200 g or more during pregnancy showed no significant difference in outcome to those who had received none.

"Our study," continued Dr. Andersson, "is by far the largest to date to examine this clinically important research question . . . and the data were not suggestive of a significant increased risk among exposed pregnancies, regardless of topical-corticosteroid potency or the amount used."

"Overall, we believe these are reassuring findings on the fetal-safety profile of topical corticosteroids use in pregnancy in relation to birth-weight-related outcomes," he said.

"Further studies on the placental passage and metabolism of the individual corticosteroids would (give) useful insights to increase our knowledge on the actual potential exposure to the fetus as little research is currently available."

SOURCE: JAMA Dermatology, online May 5, 2021.