Prednisone during Pregnancy – Safety, Risks & Precautions

Key Takeaways

• Prednisone is a type of steroid which is used to treat inflammatory bowel diseases, asthma, and other severe allergic reactions.
• Pregnant women should take prednisone only if their doctor prescribes it.
• Only small amounts of prednisone cross the placenta to reach the baby during pregnancy. 
• Long-term use or high doses of prednisone in pregnancy may potentially cause side effects like preterm delivery, low birth weight, or mild growth restriction.

The recommendation of prednisone during pregnancy happens in cases where the expecting mother is suffering from asthma or inflammatory bowel disease (IBD) (1). In such cases, doctors may prescribe corticosteroids like prednisone if the benefits outweigh the potential risks. While many corticosteroids are unsafe during pregnancy, knowing what and when is recommended is essential. If you have been suggested predisone in pregnancy, you might wonder about its effect on the growing baby and whether it is safe, and under what conditions. MotherToBaby reports that current evidence does not show a significant increase in birth defects with prednisone/prednisolone, but long-term use can have negative effects (2). Read this article to learn how prednisone and pregnancy work together, the benefits and side effects, and some common questions!

What Is Prednisone?

Prednisone is a corticosteroid which can be given either orally or through a nebuliser. As per the Cleveland Clinic, this drug lowers the concentration of inflammation-causing molecules in the body, basically slowing down an overactive immune system and reducing inflammation in the body. This medication is used to treat conditions affecting various parts of the body, allergies, hormonal imbalances, connective tissue problems, ulcerative colitis, heart conditions, asthma, arthritis, and other inflammatory diseases (3). Prednisone is most commonly recommended 1-4 times a day or every alternate day, along with food.

The time when you are carrying a child, it is important to exercise precautions and be cautious about what medications you are taking. So, is prednisone safe during pregnancy? Let’s find out!

Can You Take Prednisone While Pregnant?

In some cases, prednisone may be prescribed during pregnancy if the benefits outweigh the potential risks. However, the decision should be made in consultation with a doctor who can assess your specific medical condition and tailor the treatment plan to minimize risks. It should be used at the lowest effective dose for the shortest duration necessary. Regular monitoring and consideration of alternative treatments may also be part of the plan.

Your doctor may recommend prednisone while pregnant first trimester if the benefits outweigh the risks. Similarly, the safety of prednisone in pregnancy 3rd trimester hovers over “acceptable,” and is used only when medically necessary to control the ongoing infection.

When Can Pregnant Women Take Prednisone?

Your doctor may recommend prednisone if the benefits outweigh the risks. Here are the following cases where you may be recommended prednisone for pregnancy:

• You are experiencing severe allergic reactions, for which your doctor may prescribe prednisone in combination with an anti-allergic drug (4).
• Autoimmune disorders, such as systemic lupus erythematosus (SLE), antiphospholipid syndrome, asthma, and hepatitis.
• Hyperandrogenism in which the pregnant woman contains elevated male sex hormones produced by the fetus. It could result in low uterine activity and even pregnancy loss (5).
• You have rheumatoid arthritis or inflammatory bowel disease for which the doctor may suggest prednisone (6).

Benefits of Prednisone in Pregnancy

Taking prednisone during pregnancy can help with certain conditions. Some of the conditions this medication may help with are given below:

1. Treatment of Dermatological Conditions

Prednisone is very effective when it comes to treating skin ailments, such as eczema, contact dermatitis, seborrheic dermatitis, allergic rashes, psoriasis and so on. It is also known to regulate and maintain a stable balance of electrolytes in the bloodstream.

2. Treatment of Autoimmune Diseases

As prednisone controls the output of the immune system, it can control responses preventing the immune cells from attacking and killing the other healthy cells in the body. Autoimmune diseases like lupus are often treated with prednisone.

3. Treatment of Bone Problems

Various musculoskeletal ailments like chronic arthritis, osteoarthritis and gout are treated by prednisone.

4. Treatment of Endocrine Disorders

Endocrine or hormone-related conditions like nonsuppurative thyroiditis, hypercalcemia and adrenal hyperplasia can be treated by prednisone.

5. Treatment of Respiratory Ailments

Prednisone offers respite from the symptoms of many respiratory problems, including pneumonia, sarcoidosis, asthma, tuberculosis, and Loeffler’s syndrome.

Side Effects of Taking Prednisone in Pregnancy

There are a few potential side effects that can arise from taking prednisone during your pregnancy. They include:

1. Digestive Conditions

Digestive ailments like stomach aches, gas, bloating, passing blood in the stools, nausea and pancreatitis can occur because of prednisone.

2. Birth Defects

Taking prednisone can slightly raise the likelihood of birth defects and low birth weight in babies. However, prednisone in early pregnancy carries a smaller risk. Prednisone has been known to raise the risk of the baby developing an oral cleft by three times (7).

3. Sleeplessness

Consistent use of prednisone has been associated with symptoms of insomnia. In fact nearly, three-quarters of all patients on the medication complain of sleeplessness as a side effect.

4. Increase in Weight

People may experience an increase in body weight because of prolonged use of prednisone (8).

How Much Amount of Prednisone Should Pregnant Women Take?

Your doctor might keep the dose of prednisolone while pregnant under 20mg/day depending on the gravity of the condition. But, the appropriate dosage of prednisone for pregnant women can vary widely depending on the specific medical condition being treated and individual factors. It’s crucial to follow your healthcare provider’s guidance regarding the dosage.

In general, the goal when using prednisone during pregnancy is to use the lowest effective dose for the shortest duration necessary to manage the medical condition.

Precautionary Tips

Since prednisone is known to impact your health as well as your pregnancy, you must follow a few precautionary tips before taking this medication:

• Always consult a doctor before using prednisone while you are pregnant. Furthermore, do follow their dosage and timing recommendations strictly.
• Stopping the use of prednisone abruptly can cause lightheadedness, reduced blood pressure, breathing problems, drop in blood sugar levels, and so on.
• Oral prednisone is more likely to affect the foetus as a higher amount enters the bloodstream, so you can obtain the inhalant form as an alternative.

FAQs

1. Can prednisone be used in infertility treatment with repeated IVF failure for women?

Prednisone is sometimes considered in cases of repeated IVF (in vitro fertilization) failure, especially when autoimmune or inflammatory factors are suspected. It’s not a standard infertility treatment but may be used in specific situations after consultation with a fertility specialist. The decision should be made based on a thorough evaluation of the individual’s medical history and underlying causes of IVF failure.

2. Does prednisone prevent miscarriage?

A 2006 study involving 80 women revealed that employing a combined approach involving prednisone, progesterone, aspirin, and folate significantly increased the likelihood of successful live births in women experiencing recurrent miscarriages of unknown origin (9).

3. Can prednisone cause withdrawal symptoms?

Stopping the course of medication abruptly might result in a few withdrawal symptoms, such as extreme fatigue, weakness, fever, slower movement, weight loss, diarrhoea, salt craving, changes in skin colour, and more. If you plan to stop or reduce the medication, it is best to consult a doctor.

4. How long does prednisone take to get out of the system once you stop taking it?

Prednisone can get out of the system within a day, but its side effects may still persist for some more time or take lober to reverse.

4. Can prednisone affect my unborn baby if taken during pregnancy?

Prednisone can have grave effects in the mother if taken for a long time, causing preterm delivery or low birth weight. However, it has been a challenge to differentiate whether the adverse effects are due to medication or the medication condition for which prednisone is recommended. Thus, your doctor will only prescribe prednisone to you during pregnancy and for a limited time only when they feel strongly about its benefits outweighing the risks (2).

5. Should I stop my course of prednisone once I get pregnant?

If your doctor has prescribed prednisone for the management of asthma or other skin issues and you become pregnant while taking prednisone, it is advised to not stop the medication on your own. Consult your doctor for the reduced dosage or any other alternative (10).

Studies show that early-term foetuses are not affected by prednisone mostly because the placenta prevents the drug from entering the amniotic fluid. Furthermore, the baby’s liver is unable to activate prednisone until after the first trimester. Prednisone can cause severe complications in pregnant women but is often recommended even during pregnancy as the effects of the ailments treated by it are far worse.

Also Read:

Doxinate Oral when Pregnant
Taking Tramadol in Pregnancy
Taking Loratadine When Pregnant
Should You Take Omeprazole during Pregnancy?

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Sources References

1. National Library of Medicine – Drugs for Autoimmune Inflammatory Diseases: From Small Molecule Compounds to Anti-TNF Biologics

2. MotherToBaby – Prednisone/Prednisolone

3. Cleveland Clinic – Prednisone Tablets

4. National Institutes of Health – NAEPP Working Group Report on Managing Asthma During Pregnancy: Recommendations for Pharmacologic Treatment

5. National Library of Medicine – Fertility and pregnancy outcome in a woman with classic congenital adrenal hyperplasia

6. National Library of Medicine – A review of systemic corticosteroid use in pregnancy  and the risk of select pregnancy and birth outcomes

7. National Library of Medicine – Birth defects after maternal exposure to corticosteroids: prospective cohort study and meta-analysis of epidemiological studies

8. National Kidney Foundation – What You Need To Know About Prednisone

9. National Library of Medicine – A combination treatment of prednisone, aspirin, folate, and progesterone in women with idiopathic recurrent miscarriage: a matched-pair study

10. MedlinePlus – Prednisone