Updated evidence-based (S2e) European Dermatology Forum guideline on topical corticosteroids in pregnancy

Background: Topical corticosteroids may be needed for treating skin conditions in pregnancy. Nevertheless, only limited data on the fetal effects of topical corticosteroids are available. Objective: To update an evidence-based guideline on the safe use of topical corticosteroids in pregnancy. Methods: A guideline subcommittee of the European Dermatology Forum updated the guideline by adding and appraising new evidence. Results: The current best evidence from 14 observational studies with 1 601 515 study subjects found no significant associations between maternal use of topical corticosteroids of any potency and some adverse pregnancy outcomes including mode of delivery, birth defect, preterm delivery and fetal death. However, maternal use of potent/very potent topical corticosteroids, especially in large amounts, is associated with an increase in the risk of low birthweight. Conclusion: Mild/moderate topical corticosteroids should be preferred to potent/very potent ones in pregnancy. The well-known topical side-effects of corticosteroids on the mother's side need to be considered as well.