Treatment may be initiated on a short-term basis for acute conditions. Alternatively, treatment may be more or less ongoing for severe chronic diseases such as asthma or a variety of other autoimmune conditions when disease symptoms do not remit in pregnancy. In early pregnancy, steroids are usually given for treating recurr ing miscarriages or foetal abnormalities. Treatment may be initiated on a short-term basis for acute conditions. A number of cohort and case controlled studies in humans suggest maternal corticosteroid use in the first trimester produces a slight increased risk of cleft lip with or without cleft palate (increased from 1 out of 1000 to 3 to 5 out of 1000 infants).

Our inclusion criteria were as follows: systemic administration (PO, IV, IM), exposure at least during the first trimester of pregnancy to prednisone, prednisolone, methylprednisolone, cortisone, dexamethasone, hydrocortisone, fluocortolone, betamethasone, or triamcinolone for any indication, duration or dosage. Endogenous steroid hormone exposure during pregnancy has been of interest in studies of duration of gestation, fetal size, twin pregnancies, control of labor, nausea and vomiting in pregnancy, pregnancy-induced hypertension, and other disease states (5–9). Amounts of glucocorticoids excreted into breast milk are low with a total infant daily dose calculated to be up to 0.23% of the maternal daily dose. We comply with the HONcode standard for trustworthy health information -

Among Danish women with Crohn’s disease, corticosteroids were not associated with reduced birth weight after adjusting for gestational age and disease activity (adjusted risk ratio, 1.1; 95% CI, 0.2-5.7).Several disease-specific studies have also examined corticosteroid use and risk of preterm birth.

This drug should only be used during pregnancy if the benefit outweighs the potential risk to the fetusTeratogenicity including increased incidence of cleft palate have occurred in animal studies. There is the possibility of adrenal cortex suppression in the newborn with long term use in the mother; however the short term use of corticosteroids antepartum for the prevention of respiratory distress syndrome does not seem to pose a risk to the fetus or the newborn infant. Babies born before the full term (i.e. The studies have generally produced weak and inconsistent findings because the hormone levels were either not available or lacked specificity or because surrogate measures of exposure to altered steroid hormone levels … Reduced placental and birth weight have been recorded in animals and humans after long term treatment. Only those exposed to topical corticosteroids had a higher risk of cleft lip with or without cleft palate (odds ratio, 1.45; 95% CI, 1.03-2.05).Inconsistencies across these studies, as speculated by authors of the NBDPS analysis, may result from a lack of information on the dose of drug used by the mother, the indication for its use, or any measure of the severity of the underlying maternal disease for which the corticosteroids were prescribed.

This translates to a very low absolute risk for clefts, which occur in the general population in approximately 1 in 1,000 births. Recent estimates for oral clefts suggest a low elevation in risk, if any at all. However, the safety of corticosteroid use with respect to risk of specific birth defects, preterm delivery, and low birth weight has been the subject of debate over some time.Concerns about the teratogenicity of corticosteroids were raised as early as the 1950s, based on animal studies suggesting an increased risk for oral clefts. If this drug is necessary, the lowest dose should be prescribed as high doses of corticosteroids for long periods could produce infant growth and development problems and interfere with endogenous corticosteroid production. Steroids Other Than Dexamethasone May Also Help Battle COVID-19 Future studies of pregnancy safety for medications used to treat maternal diseases that themselves are potentially linked to adverse outcomes must incorporate appropriate measures of disease type and disease severity in the study designs. Corticosteroids are not the same as steroids used by bodybuilders. Doctors often prescribe steroid drugs known as corticosteroids for preterm labour. A number of cohort and case controlled studies in humans suggest maternal corticosteroid use in the first trimester produces a slight increased risk of cleft lip with or without cleft palate (increased from 1 out of 1000 to 3 to 5 out of 1000 infants).

The association between corticosteroids and oral clefts has also been observed in some human epidemiologic studies. However, results of these studies have been inconsistent.Similar to the NBDPS findings, in a large Danish cohort study covering 832,636 live births from 1996 to 2008, exposure to any corticosteroids during the first trimester was not associated with an increased risk for cleft lip or cleft palate.