title: Evidence-based (S3) guideline on topical corticosteroids in pregnancy.
abstract: Women with skin conditions may need topical corticosteroids during pregnancy. However, little is known about the effects of topical corticosteroids on the fetus. A guideline subcommittee of the European Dermatology Forum was organized to develop an evidence-based guideline on the use of topical corticosteroids in pregnancy (http://www.euroderm.org/edf/images/stories/guidelines/EDF-Guideline-on-Steroids-in-Pregnancy.pdf). The evidence from a Cochrane Review suggested that the major possible adverse effects on the fetus of topical corticosteroids were orofacial clefts when used preconceptionally and in the first trimester of pregnancy, and fetal growth restriction when very potent topical corticosteroids were used during pregnancy. To obtain robust evidence, a large population-based cohort study (on 84,133 pregnant women from the U.K. General Practice Research Database) was performed, which found a significant association of fetal growth restriction with maternal exposure to potent/very potent topical corticosteroids, but not with mild/moderate topical corticosteroids. No associations of maternal exposure to topical corticosteroids of any potency with orofacial cleft, preterm delivery and fetal death were found. Moreover, another recent Danish cohort study did not support a causal association between topical corticosteroid and orofacial cleft. The current best evidence suggests that mild/moderate topical corticosteroids are preferred to potent/very potent ones in pregnancy, because of the associated risk of fetal growth restriction with the latter.
authors: Department of Dermatology and Centre for Evidence-Based Medicine, Chang Gung Memorial Hospital at Chiayi, Chang Gung University College of Medicine, Chiayi, 61363, Taiwan. chingchi@cgmh.org.tw
authors: C-C
authors: CC
authors: Chi
authors: G
authors: G
authors: Kirtschig
authors: W
authors: W
authors: Aberer
authors: J-P
authors: JP
authors: Gabbud
authors: J
authors: J
authors: Lipozenčić
authors: S
authors: S
authors: Kárpáti
authors: U-F
authors: UF
authors: Haustein
authors: T
authors: T
authors: Zuberbier
authors: F
authors: F
authors: Wojnarowska
mesh_terms: D000014:Abnormalities, Drug-Induced / Q000517:prevention & control*; D000279:Administration, Cutaneous; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage / Q000009:adverse effects* / Q000378:metabolism; D000818:Animals; D001682:Biological Availability; D019317:Evidence-Based Medicine; D005260:Female; D006801:Humans; D018811:Maternal Exposure; D010920:Placenta / Q000378:metabolism; D017410:Practice Guidelines as Topic; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy*; D012871:Skin Diseases / Q000188:drug therapy*; D013723:Teratogens
chemical_list: D000305:Adrenal Cortex Hormones; D013723:Teratogens