CORTICOSTEROIDS DURING PREGNANCY AND ORAL CLEFTS - A CASE-CONTROL STUDY

The question of whether systemic use of corticosteroids during the fir st trimester of pregnancy increases the risk of congenital malformatio ns in people has still not been resolved. Here, we present the results of a case-control study on the relationship of corticosteroids during pregnancy and oral clefts in the newborn infant. Data are derived fro m the Spanish Collaborative Study of Congenital Malformations (ECEMC). Case subjects were 1,184 liveborn infants with nonsyndromic oral clef ts. The results of the logistic regression analysis, show a relationsh ip between exposure to corticosteroids during the first trimester of p regnancy and an increased risk of cleft lip (with or without cleft pal ate) in the newborn infants (OR = 6.55; CI = 1.44-29.76; P = 0.015), c ontrolled for potential confounder factors, such as maternal smoking, maternal hyperthermia, first-degree malformed relatives with cleft lip with or without cleft palate, and maternal treatment with antiepilept ics, benzodiazepines, metronidazole, or sex hormones during the first trimester of pregnancy. Thus, we believe that the use of corticosteroi ds during the first trimester of pregnancy, should be restricted to th e following situations: for life-threatening situations, for those dis eases without any other safe therapeutic alternative, or for those cas es with replacement therapy. Teratology 58:2-5, 1998. (C) 1998 Wiley-L iss, Inc.