0
Original Investigation |

Pregnancy Outcomes After Maternal Exposure to Topical Corticosteroids:  A UK Population-Based Cohort Study

Ching-Chi Chi, MD, MMS, DPhil, FAAD1; Shu-Hui Wang, MD, MS2; Richard Mayon-White, MBBS, FRCP, FFPH3; Fenella Wojnarowska, MA, DM, FRCP4
[+] Author Affiliations
1Department of Dermatology and Centre for Evidence-Based Medicine, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Chiayi, Taiwan
2Department of Dermatology, Far Eastern Memorial Hospital and Oriental Institute of Technology, New Taipei, Taiwan
3Department of Primary Health Care Sciences, University of Oxford, Oxford, England
4Nuffield Department of Clinical Medicine, University of Oxford, Oxford, England
JAMA Dermatol. 2013;149(11):1274-1280. doi:10.1001/jamadermatol.2013.5768.
Text Size: A A A
Published online

Importance  Topical corticosteroids are indicated for pregnant women with skin conditions, but their safety in pregnancy is not fully understood.

Objective  To investigate whether maternal exposure to topical corticosteroids results in adverse pregnancy outcomes.

Design  Retrospective cohort study.

Setting  United Kingdom National Health Service.

Participants  A total of 2658 pregnant women exposed to topical corticosteroid and 7246 unexposed pregnant women.

Exposure  Topical corticosteroids dispensed during pregnancy.

Main Outcomes and Measures  Orofacial cleft, low birth weight, preterm delivery, fetal death, low Apgar score, and mode of delivery.

Results  No associations of maternal topical corticosteroid exposure with orofacial cleft, low birth weight, preterm delivery, fetal death, low Apgar score, and mode of delivery were found in the primary analysis (adjusted risk ratio [RR], 1.85 [95% CI, 0.22-15.20] [P = .57]; 0.97 [95% CI, 0.78-1.19] [P = .75]; 1.20 [95% CI, 0.73-1.96] [P = .48]; 1.07 [95% CI, 0.56-2.05] [P = .84]; 0.84 [95% CI, 0.54-1.31] [P = .45]; and P = .76, respectively). Stratified analyses based on potency did not reveal any significant associations in most of these categories either, but an exploratory analysis showed a significantly increased risk of low birth weight when the dispensed amount of potent or very potent topical corticosteroids exceeded 300 g during the entire pregnancy (adjusted RR, 7.74 [95% CI, 1.49-40.11]; P = .02).

Conclusions and Relevance  This study reassuringly showed no associations of maternal topical corticosteroid exposure with orofacial cleft, preterm delivery, fetal death, low Apgar score, and mode of delivery. With this study and all available evidence taken together, the risk of low birth weight seems to correlate with the quantity of topical corticosteroid exposure.

Sign In to Access Full Content

Don't have Access?

Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more

Subscribe for full-text access to content from 1998 forward and a host of useful features

Activate your current subscription (AMA members and current subscribers)

Purchase Online Access to this article for 24 hours

Figures

Tables

References

Correspondence

CME
Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).
Submit a Comment

Multimedia

Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

Related Content

Customize your page view by dragging & repositioning the boxes below.

Multimedia Related by Topic

Author Interview

Articles Related By Topic
Related Topics
Jobs
brightcove.createExperiences();