title: Pregnancy outcomes after maternal exposure to topical corticosteroids: a UK population-based cohort study.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  Retrospective cohort study.
  
  
  METHODS
  United Kingdom National Health Service.
  
  
  METHODS
  A total of 2658 pregnant women exposed to topical corticosteroid and 7246 unexposed pregnant women.
  
  
  METHODS
  Topical corticosteroids dispensed during pregnancy.
  
  
  METHODS
  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
  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.
authors.affiliation: Department of Dermatology and Centre for Evidence-Based Medicine, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Chiayi, Taiwan.
authors.forename: Ching-Chi
authors.initials: CC
authors.lastname: Chi
authors.forename: Shu-Hui
authors.initials: SH
authors.lastname: Wang
authors.forename: Richard
authors.initials: R
authors.lastname: Mayon-White
authors.forename: Fenella
authors.initials: F
authors.lastname: Wojnarowska
mesh_terms: D000014:Abnormalities, Drug-Induced / Q000175:diagnosis / Q000209:etiology*; D000287:Administration, Topical; D001034:Apgar Score; D001724:Birth Weight; D015331:Cohort Studies; D003879:Dermatologic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage / Q000009:adverse effects*; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D018811:Maternal Exposure / Q000009:adverse effects*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000139:chemically induced*; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D063465:Skin Cream; D012871:Skin Diseases / Q000188:drug therapy; D006113:United Kingdom
chemical_list: D003879:Dermatologic Agents; D005938:Glucocorticoids