NEW ORLEANS – The use of potent or very potent topical corticosteroids in pregnancy is associated with a significantly increased risk of fetal growth retardation, according to a very large population-based cohort study.
Fortunately, maternal exposure to topical corticosteroids was not associated with any other adverse outcomes, including miscarriage, stillbirth, preterm delivery, or orofacial cleft, Dr. Linda F. Stein said in highlighting the study findings at the annual meeting of the American Academy of Dermatology.
Dr. Stein, director of dermatology research at Henry Ford Hospital in Detroit, singled out the study for special attention because its unusually large size makes for convincingly strong conclusions regarding an issue for which there has been a dearth of data: the safety of topical steroids in pregnancy.
Investigators at Chang Gung University in Taoyuan, Taiwan, and the University of Oxford (England) used the U.K. General Practice Research Database to identify 35,503 women who had been prescribed topical corticosteroids during or shortly before pregnancy, and a control group comprising 48,630 unexposed pregnant women.
Maternal exposure to potent or very potent topical steroids was associated with an adjusted 2.1-fold increased relative risk of fetal growth restriction. Moreover, a significant dose-response relationship was found, such that for every 30 g of prescribed potent or very potent topical steroids, the risk of fetal growth retardation climbed by about 3%. The risk rose with the increasing potency of the topical medication.
The investigators estimated that 168 pregnant women would have to receive potent or very potent topical steroids in order to result in one additional case of fetal growth restriction (J. Invest. Dermatol. 2010 Dec. 30 [doi:10.1038/jid.2010.392]).
Dr. Stein had no relevant financial interests.