499 No identified risk in use of topical corticosteroids during pregnancy

December 21, 2016

written by Brian R McAvoy

Clinical question
How safe are topical corticosteroids in pregnancy?

Bottom line
There was no association found between maternal use of topical corticosteroids of any potency and an increase in adverse pregnancy outcomes, including mode of delivery, congenital abnormality, preterm delivery, foetal death and low Apgar score. There was some association between low birthweight and maternal use of potent or very potent topical steroids, especially with very large cumulative doses used in pregnancy.

Caveat
The overall quality of evidence was low because all of the available studies were observational. Randomised controlled trials were not feasible in pregnant women due to ethical concerns about possible exposure of the foetus to an experimental treatment.

Context
Topical corticosteroids are the most frequently prescribed dermatological treatment, and are often used by pregnant women with skin conditions.

Cochrane Systematic Review
Ching-Chi C et al. Safety of topical corticosteroids in pregnancy. Cochrane Reviews, 2015, Issue 10. Art. No.: CD007346.DOI: 10.1002/14651858. CD007346.pub3. This review contains 14 studies involving 1,601,515 participants.

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.