Maternal Systemic Use of Corticosteroids and Infant Congenital Malformations

Abstract

Maternal use of systemic corticosteroids has been linked to an increased risk of orofacial clefts in the offspring. One reason for this is animal experiments where cleft palate was readily induced by corticosteroids, notably in mice. Most previous studies which have identified such a risk in man were retrospective case-control studies of dubious scientific value. At present there are some large cohort studies available but with varying results. In the study from the Swedish health registers, presented here, an increased risk for cleft lip/palate was identified but it did not reach statistical significance. The risk ratio for cleft palate was non-significantly below 1.0 but the two estimates did not differ significantly. A causal association may exist, however. If so, the absolute risk after such an exposure is low. An association between use of prednisolone and an increased risk for cardiovascular defects was seen but needs verification.