Study Looks at Corticosteroids and Pregnancy

Although earlier studies have made a link between <"">oral corticosteroids and orofacial clefts in babies born to women taking these drugs during pregnancy, the Canadian Medical Association Journal (CMAJ) says that the increased link does not exist.

This finding does not mean that no risk exists. Dermatologic corticosteroids were linked to greater risks for cleft lip, both with and without cleft palate, wrote Science Daily.

Cleft lips and cleft palates occur when parts of the lip or palate do not completely fuse together early in the first trimester of pregnancy, a time when many women are not aware of their pregnancy. Corticosteroids are used in the treatment of asthma, allergies, eczema and psoriasis, autoimmune diseases, and cancer.

Science Daily wrote that, according to CMAJ, prior studies were smaller and found the increased likelihood of orofacial clefts when corticosteroids are taken during pregnancy in studies conducted with animals.

This study was conducted by researchers in Copenhagen, Denmark, and reviewed data from 832,636 live births from January 1996 to September 2008; data was derived from the Danish Medical Birth Registry, the Danish Prescription Drug Register, and the National Hospital Discharge Register.

The team studied 163,494 women (19.6%) who used corticosteroids at least once in the four weeks before pregnancy and up to birth of their child, explained Science Daily. CMAJ wrote that corticosteroid exposure during the first trimester of pregnancy took place in 51,973 of the cases.

Of the corticosteroids studied, the most common were dermatological (43.3%) and were followed by other topical solutions (eye or ear drops), nasal sprays (21.6%), inhalants, (14.3%), and oral medications (4.2%), said Science Daily. Women using corticosteroids in the first trimester accounted for 6.2% or 51,973; 1232 orofacial clefts were identified in infants up to age one, wrote Science Daily.

“Women who used any corticosteroid during the first trimester were not significantly more likely to bear offspring with a cleft lip with or without a cleft palate or a cleft palate alone than women who did not use any corticosteroid during the first trimester,” wrote Dr. Anders Hviid and Ditte Mølgaard-Nielsen, Statens Serum Institute, Copenhagen, Denmark, quoted Science Daily.

Of note, the team explained that, “However, the use of dermatologic corticosteroids was associated with an increased risk of cleft lip with or without cleft palate,” the authors wrote, quoted Science Daily, which added that oral, inhalants, nasals and other topical corticosteroids were not linked to this increased risk.

The team concluded, “our results add to the safety information for a class of drugs commonly used during pregnancy,” warning that, regardless, while the study suggests that “moderate to strong risks” are not likely, the study does not say that corticosteroids are completely safe, quoted Science Daily.

What the study background did indicate is that the “risk of orofacial clefts in infants and the use of corticosteroids during pregnancy is unclear from the available evidence,” wrote CMAJ. The study was a 12-year nationwide cohort.

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