Maternal corticosteroid use and risk of selected congenital anomalies

Evidence for the teratogenicity of corticosteroids in humans is limited and has resulted in inconsistent recommendations regarding their use during ea rly pregnancy. We examined the association between women's corticosteroid u se during the periconceptional period (1 month before to 3 months after con ception) and delivering infants with selected congenital anomalies. Data we re derived from a population-based case-control study that included cases o f orafacial clefts (n = 662), conotruncal heart defects (n = 207), neural t ube defects (n = 265), and limb reduction defects (n = 165), Information on medication use was collected via maternal telephone interviews. Corticoste roid use was associated with an increased risk for isolated cleft lip with or without cleft palate (odds ratio 4.3, 95% confidence interval 1.1-17.2) and isolated cleft palate (odds ratio 5.3, 95% confidence interval 1.1-26.5 ). Increased risks were not observed for the other anomaly groups studied. These data in conjunction with other epidemiologic data suggest a possible causal association between cleft lip and palate and corticosteroid use. (C) 1999 Wiley-Liss, Inc.