Topical steroids are the most commonly used medicines for skin conditions. Pregnant women may need topical steroids to treat skin conditions but it is unclear if they are safe or harmful during pregnancy. To prove its safety, randomized controlled trials and cohort studies of topical corticosteroids in pregnant women show that there is no statistically significant difference between pregnant women who use and those who do not use topical corticosteroids.

However, several studies showed that large doses of topical corticosteroids are associated with low birth weight.

From Cochrane Reviews:

Randomized controlled trials and cohort studies of topical corticosteroids in pregnant women, and case-control studies comparing maternal exposure to topical corticosteroids between cases and controls were included where outcomes were those we had pre-specified. Outcomes included mode of delivery, congenital abnormality, birth weight, preterm delivery, stillbirth, and low Apgar score.

Two authors independently applied selection criteria, extracted data, and assessed the quality of the included studies. A third author was available for resolving differences of opinion.

Seven studies, including 2 cohort and 5 case-control studies, of 659,675 participants were included. We did not undertake a meta-analysis due to considerable methodological heterogeneity. The available data was limited and mainly on orofacial cleft. Most studies did not find significant associations between topical corticosteroids and pregnancy outcomes including mode of delivery, congenital abnormality, preterm delivery, and stillbirth. One study found a significant association between first trimester topical corticosteroid use and orofacial cleft, and another found a significant association between very potent topical corticosteroids and low birth weight. Cohort studies with comprehensive outcome measures, assessment of effects of corticosteroid potency and dose, application methods, and reasons for giving them, and a very large sample size are needed.

Currently limited and inconclusive data are unable to detect an association between topical corticosteroids and congenital abnormality, preterm delivery, or stillbirth.

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