Current topics in Allergy

Steroid Use During Pregnancy Not Linked to Facial Clefts

  Corticosteroid use during pregnancy was not associated with facial clefts in the infants, according to the results of a 12-year nationwide cohort study using data about all live births in Denmark and from Danish health registries.

The investigators gathered data on all live births in Denmark from January 1, 1996, to September 30, 2008. The analysis included those live births for which nationwide health registry data were available regarding the use of corticosteroids during pregnancy, the diagnosis of an orofacial cleft, and possible confounding factors.

  Of 832,636 live births reported during the study period, 51,973 were associated with corticosteroid exposure during the first trimester. Within the first year of life, 1232 infants were diagnosed with isolated orofacial clefts (cleft lip, cleft palate, or cleft lip and cleft palate), including 84 infants who had been exposed to corticosteroids during the first trimester of pregnancy.

  Corticosteroid use was not associated with any statistically significant increased risk for orofacial clefts, including cleft lip with or without cleft palate (prevalence odds ratio [OR], 1.05; 95% confidence interval [CI], 0.80 - 1.38), or cleft palate alone (prevalence OR, 1.23; 95% CI, 0.83 - 1.82). Overall results were consistent for prevalence odds ratios for risk for orofacial clefts when broken down by method of steroid delivery (ie, oral, inhalant, nasal spray, or topical). Although heterogeneity was not significant among results with these varying delivery methods, the odds ratio for cleft lip with or without cleft palate associated with the use of dermatologic corticosteroids specifically (and not other topical uses) was 1.45 (95% CI, 1.03 - 2.05).

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