Funding sources No external funding.
Evidence-based (S3) guideline on topical corticosteroids in pregnancy
Article first published online: 29 SEP 2011
© 2011 The Authors. BJD © 2011 British Association of Dermatologists
British Journal of Dermatology
Volume 165, Issue 5, pages 943–952, November 2011
How to Cite
Chi, C.-C., Kirtschig, G., Aberer, W., Gabbud, J.-P., Lipozenčić, J., Kárpáti, S., Haustein, U.-F., Zuberbier, T. and Wojnarowska, F. (2011), Evidence-based (S3) guideline on topical corticosteroids in pregnancy. British Journal of Dermatology, 165: 943–952. doi: 10.1111/j.1365-2133.2011.10513.x
Conflicts of interest T.Z.: consultant for Ansell, Bayer Schering, DST, Fujisawa, HAL, Henkel, Kryolan, Leti, MSD, Novartis, Procter and Gamble, Sanofi-Aventis, Schering Plough, Stallergenes, and UCB; the others, none.
- Issue published online: 25 OCT 2011
- Article first published online: 29 SEP 2011
- Accepted manuscript online: 5 JUL 2011 01:10PM EST
- Accepted for publication 23 June 2011
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.