Synopsis The evidence to date regarding corticosteroid exposure in pregnancy and select pregnancy and birth outcomes is limited and inconsistent. Here we provide a narrative review of published literature summarizing the findings for oral clefts, preterm birth, birth weight, preeclampsia and gestational diabetes mellitus. Whenever possible, the results are limited to oral or systemic administration with a further focus on use in autoimmune disease. Although previous studies of corticosteroid exposure in pregnancy reported an increased risk of oral clefts in the offspring, more recent studies have not replicated these findings. Further, most of the literature lacks robust statistical analysis accounting for underlying disease or disease activity. The evidence to date suggests that first trimester corticosteroid use may confer a small increase in the odds of cleft lip with or without cleft palate, although data are conflicting and it is unknown to what extent the underlying maternal disease may contribute. There is little support that systemic corticosteroid use in pregnancy independently causes increases in risks of preterm birth, low birth weight, or preeclampsia. There is not sufficient evidence to determine whether corticosteroids could contribute to gestational diabetes mellitus.

Infantile hemangiomas (IHs) are the most common vascular tumors in infants, appearing in early infancy and ultimately regressing with time. Clinical presentation may vary, with a minority of lesions causing impairment of vital function (e.g., respiratory or visual obstruction), permanent scarring, and/or disfigurement. The pathogenesis of IH is complex and poorly understood. Risk factors implicated in their development include preterm birth and placental anomalies. IH presents a myriad of clinical challenges, including correct diagnosis and whether or not to pursue treatment. This article is a review of the current literature regarding pathogenesis, clinical presentation, treatment, and prognosis of IH.

Women with RA and JIA are at increased risk for PTD. Maternal disease activity and corticosteroid use may contribute to some of this excess risk. This article is protected by copyright. All rights reserved.

ObjectiveTo add to data on adverse birth outcomes accounting for disease activity in women with psoriatic arthritis (PsA) and ankylosing spondylitis (AS).MethodsData were analyzed from women enrolled in the Organization of Teratology Information Specialists Autoimmune Disease Project from 2004 to 2018. Disease activity was measured according to the Health Assessment Questionnaire (HAQ) or Routine Assessment of Patient Index Data 3 (RAPID3) scores. Poisson regression was used to estimate adjusted risk ratios (ARRs) with 95% confidence intervals (95% CIs) for selected adverse pregnancy outcomes.ResultsCompared to healthy controls (n = 717), women with PsA (n = 117) were at increased risk for moderate preterm delivery (32–36 weeks’ gestation) (ARR 1.81, 95% CI 1.01–3.26), oligohydramnios (ARR 3.79, 95% CI 1.34–10.74), and cesarean delivery (ARR 1.63, 95% CI 1.26–2.12). Women with AS (n = 129) had an increased risk of delivering infants requiring intensive care (ARR 1.67, 95% CI 1.05–2.67). A high HAQ score at 32 weeks was associated with preterm delivery in women with PsA (ARR 3.82, 95% CI 1.51–9.67). In women with AS, a high RAPID3 score was associated with cesarean delivery (ARR 5.82, 95% 1.06–31.78), and second trimester glucocorticoid use was associated with preterm delivery (ARR 4.41, 95% CI 1.57–12.41).ConclusionWomen with PsA and AS have increased risk for selected adverse pregnancy outcomes. Active disease and use of glucocorticoids may increase the risk for some adverse pregnancy outcomes in women with these conditions.