Oral corticosteroid use during pregnancy poses no risk of congenital heart defects

Exposure to oral corticosteroids during pregnancy bears no harm to the offspring in terms of the risk of congenital heart defects (CHDs), a study reports.

Using data from a register-based nationwide prevalence study including all live singleton births in Denmark, researchers looked at 1,194,687 mother-and-child pairs to assess the risk of offspring CHDs in relation to the mothers’ use of oral corticosteroids in early pregnancy.

A total of 2,032 individuals (0.17 percent) had a mother who filled a prescription for oral corticosteroids during the 0–8-week period after conception, whereas 1,142,091 (96 percent) had a mother who never used the drugs.

CHDs were documented in 11,094 individuals, yielding a prevalence rate of 93 per 10,000. The crude prevalence was higher in individuals whose mothers filled a prescription for oral corticosteroids in weeks 0–8 after conception than in those whose mothers were never exposed to the drug (32 vs 10,534; prevalence, 157 vs 92 per 10,000; prevalence ratio [PR], 1.72, 95 percent confidence interval [CI] 1.21–2.44).

However, the PR was attenuated following adjustments for maternal age, birth order, calendar year and other covariates associated with corticosteroid exposure and CHD (1.29, 95 percent CI, 0.90–1.84; p=0.16). Propensity score-matched analysis yielded similar results (PR, 1.38, 95 percent CI, 0.95–2.02).

In light of the findings, the researchers pointed out that there is no reason to refrain from corticosteroid treatment during early pregnancy, especially when there is a clear and pertinent indication.