. 2015 May 18;5:83–95. doi: 10.2147/PTT.S82975

Table 3.

Main cohort studies exploring the effects of maternal exposure to topical corticosteroids

Study characteristics	Summary of results
Population-based cohort study using the UK General Practice Research Database (84,133 pregnant women)³⁵	Significant association of fetal growth restriction with maternal exposure shortly before and during pregnancy to high- and very-high-potency TCS (adjusted RR, 2.08), but not with mild/moderate TCS.
	No associations of maternal exposure to TCS of any potency with orofacial cleft (cleft lip with or without cleft palate, and cleft palate alone), preterm delivery, and fetal death (including miscarriage and stillbirth).
Danish cohort study of all (832,636) live births over a 12-year period	No apparent association between any corticosteroid use and development of a cleft lip with or without a cleft palate in the offspring.
Maternal first-trimester exposure to corticosteroids in 51,973 pregnancies (43.3% exposed to TCS)³⁶	Increased risk of cleft lip with or without cleft palate associated with the use of TCS (OR: 1.45), but no increased risk with steroids in the form of inhalants, nasal sprays, and other topicals. Exposure to oral corticosteroids during the first trimester in none of the infants with clefts.
Retrospective cohort study performed by the UK National Health Service in 2,658 pregnant women exposed to TCS and 7,246 unexposed pregnant women³⁷	No associations with orofacial cleft, low birth weight, preterm delivery, fetal death, low Apgar score, and mode of delivery. Absence of any significant associations in most of these categories by means of stratified analyses based on potency.
	In an exploratory analysis, significantly increased risk of low birth weight when the dispensed amount of potent or very potent TCS exceeded 300 g during the entire pregnancy (adjusted RR, 7.74; P=0.02).
Norwegian report using two population-based studies, and evaluating maternal first-trimester exposure to corticosteroids (focusing on TCS)³⁸	In the case–control study, association of TCS with both cleft lip with or without palate (adjusted OR: 2.3) and cleft palate only (adjusted OR: 3.4). No evidence of this association in the cohort data, although exposure to TCS was less specifically ascertained. No associations with other types of corticosteroids.

Abbreviations: OR, odds ratio; RR, relative risk; TCS, topical corticosteroids.