Risks for my child | Cortisone in pregnancy – How dangerous is it?

Risks for my child

Low-dose and short-term therapy with glucocorticoids has few risks for the baby. When taken between the 8th and 11th week of pregnancy, study results have shown a slightly increased risk of cleft lip and palate, while the overall rate of malformations is normal. It should be noted that elevated cortisone levels are only one of many contributing triggers. In addition, cortisone therapy carries the risk of premature birth and growth disorders. Continuation of a high-dose glucocorticoid therapy should therefore always be discussed with the attending physician and regularly checked with an ultrasound device.

Dosage of cortisone during pregnancy

Different dosages are used depending on the disease to be treated. For many diseases, even low daily doses of between 1 and 10 mg are possible. The dosage of a long-term therapy is indicated with the unit prednisolone equivalent – it indicates the strength of the active substance in comparison to the common prednisolone.

During pregnancy it is possible to continue glucocorticoid therapy at low doses (less than 10 mg) without risk. Even the single injection of very high doses (up to 100 mg) does not have to be avoided in emergencies and in the case of acute attacks of disease. In the case of high-dose long-term therapy (more than 15 to 20 mg per day over a long period of time), the treatment should be discussed with the treating physician and the child’s development should be regularly monitored with the aid of an ultrasound device.

Alternatives to cortisone

In comparison to many other drugs, there are no or only a few preparations available as alternatives for glucocorticoids. The strong anti-inflammatory effect is not achieved with the help of herbal products. In addition, other drugs that inhibit the immune system generally have a much larger side effect profile.

If necessary, a different daily distribution of the medication intake can lead to a constantly lower effect level. To continue cortisone therapy during pregnancy, therefore, the use of prednisone or prednisolone should be resorted to. Due to an inactivation in the placenta, only a very small amount of the active substance reaches the child’s bloodstream.

Forms of application of cortisone in pregnancy

When using a cortisone ointment or cortisone cream there is only a very low risk for the child. When applied locally, only a very small amount of the active ingredient gets into the mother’s blood through the protective barriers of the skin. If ointments or creams containing prednisone or prednisolone are used, this proportion is also largely inactivated in the placenta.

A therapy with cortisone cream or ointment can therefore usually be continued during pregnancy. Nevertheless, consultation with the doctor treating the patient is always necessary. The cortisone spray used in the context of asthma disorders can also be used during pregnancy.

Similar to the use of ointments and creams, only a small amount of the glucocorticoid quantity of the spray reaches the circulation of the mother and the child. For safety reasons it may still be advisable to use another non-cortisone spray. For this reason, further intake during pregnancy should always be discussed with the doctor treating the child.