Evidence-based (S3) guideline on topical corticosteroids in pregnancy

C. C. Chi, G. Kirtschig, W. Aberer, J. P. Gabbud, J. Lipozencic, S. Kárpáti, U. F. Haustein, T. Zuberbierff, F. Wojnarowska

Research output: Contribution to journalArticle

48 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)943-952
Number of pages10
JournalBritish Journal of Dermatology
Volume165
Issue number5
DOIs
Publication statusPublished - Nov 2011

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Adrenal Cortex Hormones
Guidelines
Pregnancy
Fetal Development
Maternal Exposure
Fetus
Cohort Studies
Fetal Death
First Pregnancy Trimester
Dermatology
General Practice
Pregnant Women
Steroids
Databases
Skin
Research
Population

ASJC Scopus subject areas

  • Dermatology
  • Medicine(all)

Cite this

Chi, C. C., Kirtschig, G., Aberer, W., Gabbud, J. P., Lipozencic, J., Kárpáti, S., ... Wojnarowska, F. (2011). Evidence-based (S3) guideline on topical corticosteroids in pregnancy. British Journal of Dermatology, 165(5), 943-952. https://doi.org/10.1111/j.1365-2133.2011.10513.x

Evidence-based (S3) guideline on topical corticosteroids in pregnancy. / Chi, C. C.; Kirtschig, G.; Aberer, W.; Gabbud, J. P.; Lipozencic, J.; Kárpáti, S.; Haustein, U. F.; Zuberbierff, T.; Wojnarowska, F.

In: British Journal of Dermatology, Vol. 165, No. 5, 11.2011, p. 943-952.

Research output: Contribution to journalArticle

Chi, CC, Kirtschig, G, Aberer, W, Gabbud, JP, Lipozencic, J, Kárpáti, S, Haustein, UF, Zuberbierff, T & Wojnarowska, F 2011, 'Evidence-based (S3) guideline on topical corticosteroids in pregnancy', British Journal of Dermatology, vol. 165, no. 5, pp. 943-952. https://doi.org/10.1111/j.1365-2133.2011.10513.x
Chi, C. C. ; Kirtschig, G. ; Aberer, W. ; Gabbud, J. P. ; Lipozencic, J. ; Kárpáti, S. ; Haustein, U. F. ; Zuberbierff, T. ; Wojnarowska, F. / Evidence-based (S3) guideline on topical corticosteroids in pregnancy. In: British Journal of Dermatology. 2011 ; Vol. 165, No. 5. pp. 943-952.
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