Cortisone and pregnancy: what you need to know

In France, cortisone is one of the drugs allowed during pregnancy, but only on medical prescription. At right dose, it does not seem to present risks for the unborn baby. It can even be very beneficial to him in case of premature birth ...

Cortisone and pregnancy: is there a risk for the baby?

  • The potential risks of cortisone and other corticosteroids during pregnancy are still debated in the scientific community, but to date, they seem minor. In practice, they are mainly suspected of being able to promote in utero growth retardation or low birth weight in some cases, but usually only transitional problems (the child normally grows up).
  • A statistical study conducted for the INSERM (National Institute of Health and Medical Research) in 2016 * also highlighted a probable link between taking immunosuppressants, including cortisone, during pregnancy and weakening the system. immune system during the first year of life. However, the increased risk of infection is very low.
  • Finally, very high doses of cortisone could also hinder the development of the adrenal glands of the fetus. Why ? Because these glands are responsible for the production of cortisol, a natural hormone that is very similar to cortisone: in case of high exposure to cortisone, baby glands would "no longer need" to develop to synthesize cortisol.
  • But this is only theoretical: the doses allowed during pregnancy can not cause this kind of side effect.

Cortisone treatment: should it be changed during pregnancy?

  • Cortisone is commonly used to treat many chronic diseases, such as asthma, to give a common example, or multiple sclerosis.
  • If you follow this type of treatment, always consult your doctor at the beginning of your pregnancy: it will evaluate the benefit / risk ratio according to your pathology and the form of administration of cortisone. For example, in the form of aerosol or cream, the dose of cortisone passing into the blood is low: it is greater when it is taken in the form of tablets.
  • In most cases, the basic treatment with corticosteroids does not need to be modified during pregnancy.

Cortisone and premature birth: what benefits?

  • Cortisone is often given to the pregnant woman in anticipation of premature delivery. The main purpose of the treatment is to help baby breathe better at birth: cortisone "boosts" the development of its bronchi which significantly reduces the risk of respiratory distress after delivery. In addition, the administration of cortisone before premature delivery greatly reduces the risk of ventricular cerebral hemorrhage and neonatal mortality.

* Unit 1027 Inserm / University Paul Sabatier, Toulouse