Topical corticosteroids are commonly prescribed for the treatment of skin conditions like eczema or dermatitis. The topical medications work as an anti-inflammatory to reduce redness, swelling and other symptoms. These skin conditions may occur during pregnancy. Researchers recently completed a study based on the population of the United Kingdom in an effort to find out whether topical corticosteroid use by pregnant women increased risk of negative pregnancy outcomes. The study was published in the journal JAMA Dermatology

Researchers collected information from medical records of about 2,600 women who had been exposed to topical corticosteroids and about 7,200 women who had not been exposed. They looked for a connection between low birth weight, orofacial cleft, preterm delivery, low APGAR, fetal death and mode of delivery and contact with topical corticosteroids. No clear connection was found at total potency of less than 300 grams for the duration of the pregnancy. However, when pregnant women came in contact with topical corticosteroid potencies in excess of 300 grams, over the course of the entire pregnancy, an increase in low birth weight infants was noted. 

Based on the study results, use of topical corticosteroids during pregnancy can be deemed relatively safe, but only with low exposure. Higher exposure either through long-term use or applying larger amounts per use so that the total amount of exposure exceeds 300 grams during the pregnancy, may be linked to lower birth weight. Low birth weight may increase the risk of negative health outcomes for infants; some of which last well into childhood, teens and adulthood. Further research is needed on higher topical corticosteroid exposures and negative pregnancy outcomes. 

When using topical corticosteroids it is best to talk with your obstetrician and dermatologist about potential pregnancy outcomes. Always use the prescribed amount to treat your condition. Using more than the prescribed amount may be associated with low birth weight, as noted in this study, and may be associated with other side effects as noted in the medication informational packet. 

Source: Ching-Chi Chi, MD, MMS, DPhil, FAAD; Shu-Hui Wang, MD, MS; Richard Mayon-White, MBBS, FRCP, FFPH; Fenella Wojnarowska, MA, DM, FRCP. Pregnancy Outcomes After Maternal Exposure to Topical Corticosteroids: A UK Population-Based Cohort Study. JAMA Dermatol. Published online September 04, 2013. doi:10.1001/jamadermatol.2013.5768.