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Umesh Modi is a chartered accountant, and Pamini Jatheeskumar is a chartered certified accountant at Silver Levene...
  Don Lavoie is alcohol programme manager at Public Health England and Gul Root is lead...
Don Lavoie is alcohol programme manager at Public Health England and Gul Root is lead pharmacist, Health and Wellbeing Directorate, Public Health England
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pregnant1November 4 2015

A Cochrane review has said recent research adds to the evidence showing no causal associations between maternal exposure to topical steroids and pregnancy outcomes.

Updating its 2009 review, the researchers have incorporated findings from seven new studies that had been published since then and up to July 2015. The updated review now includes data from 14 observational studies and over 1,600,000 pregnancies.

Its key findings are that:

•    there appear to be no associations between mothers’ use of topical steroids of any potency and type of delivery, birth defects, premature births, or low Apgar score;
•    there is some evidence indicating a relationship between low birth weight and maternal use of potent or very potent topical steroids, especially when high doses are used in pregnancy, and this may warrant more research;
•    maternal use of mild or moderate topical corticosteroids is not related to low birth weight;
•    mild or moderately potent topical steroids may protect against death of the baby, but this was not seen when the mothers used potent or very potent topical steroids, a finding which needs further examination.

However, the researchers point out that the overall quality of evidence is low because of all the available studies being observational.

The authors point out that references such as the British National Formula do not give specific advice on prescribing topical corticosteroids for pregnant women, but that it has been assumed that use of low-potency topical steroids such as hydrocortisone is safe during pregnancy.

Links:

Cochrane announcement

Ching-Chi Chi et al. ‘Safety of topical corticosteroids in pregnancy’. Cochrane Library. Published online October 26 2015

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