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Michael Monheit
Michael Monheit
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Are steroid medications tied to oral cleft birth defects?

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Corticosteroid drugs which are used to treat asthma and other chronic ailments until recently were believed to be a cause of oral cleft birth defects in babies born to women who took the drugs during pregnancy. A newly-published study in the Canadian Medical Association Journal, however, indicates that there may not actually be a heightened risk of these birth defects.

The study, which looked at over 832,000 babies born in Denmark between 1996 and 2008, found that there was no clear link between the mothers’ use of corticosteroids and the risk of oral clefts. Specifically of the total number of babies who were a part of the study, 1,232 presented with cases of cleft lip or cleft palate. Overall, 6% of the mothers involved with the study used topical, inhaled, oral, or nasal-spray corticosteroids in the first trimester of the pregnancy.

The results of the study come as good news to women who are planning a pregnancy or who are pregnant and at the same time have been prescribed corticosteroid drugs for a chronic health issue. As with many chronic issues and pregnancy, decisions about treatment are often difficult, with both treatment and non-treatment presenting some level of risk to the fetus. In the case of corticosteroid drugs and oral cleft birth defects, which are the most common birth defect, the baby can be born without proper fusion of the roof of the mouth and the upper lip, to varying degrees of severity. Due to this perceived risk, women have often modified their dosage to the lowest levels possible.

On the other hand, non-treatment or altered treatment for chronic ailments such as asthma can present other risks to the unborn fetus. As the researchers in the current study indicate, continued treatment of asthma with corticosteroid drugs can be very important in keeping the asthma under control, as a serious asthma attack can deprive the fetus of oxygen.

While the new study does not pretend to indicate that any drugs are 100% safe, it does offer some scientific evidence to refute the link between steroid use and oral cleft birth defects. The study also distinguishes between the different forms of steroids—topical, inhaled, oral, or nasal-spray—and indicates that some forms of the medication may be safer than others. For example, the researchers point out that when taken orally, the steroids enter the bloodstream and can more likely cross into the placenta. For inhaled steroids, though, less of the drug enters into the bloodstream.

Although the study comes as welcome news, women who are prescribed corticosteroid drugs and who are considering a pregnancy should consult with their physician about the options available and the risks associated with each treatment approach.

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    In Hawaii where asthma and other allergy driven illnesses are rampant, this will be good news for familes. Thanks for getting this important information out to the public.