Can You Take Prednisone While Pregnant?

If you're pregnant and have inflammatory bowel disease (IBD), you may be concerned about the effect medications to treat IBD, such as prednisone may have on your unborn baby.

Oral steroids like prednisone are commonly used to treat IBD, and they carry the potential for a host of side effects. It's natural, when you have IBD and other inflammatory conditions, to have questions about taking prednisone during pregnancy.

Pregnant woman taking multi-vitamins
 Maria Teijeiro / OJO Images / Getty Images

Managing IBD During Pregnancy

It may be that medications for your chronic conditions are clearly needed during pregnancy—for both your health and your baby's. If your doctor recommends medications like prednisone (corticosteroids), it means they believe the risks of the drug is likely lower than the risk of not taking them.

If you have IBD, it's important to be in remission, or to have the IBD as under control as possible, before getting pregnant.

However, even if a pregnancy is unplanned, many good medication options can help control IBD inflammation. Reducing inflammation from IBD and protecting the baby are going to be the key factors in ensuring as healthy a pregnancy as possible.

Caution

It's potentially dangerous to abruptly stop taking prednisone. It's best to talk to your doctor about any concerns. You should decide whether to discontinue the medication after consulting with an obstetrician and a gastroenterologist, preferably one who specializes in IBD and pregnancy.

Possible Birth Defects

Prednisone during pregnancy has been associated with:

  • Cleft lip or palate
  • Premature delivery
  • Low birth weight

These risks appear to be small, however, and in women with IBD, evidence shows that major birth defects are not likely.

The website UpToDate, a trusted resource by doctors, says this about prednisone during pregnancy.

"Some studies have suggested that there may be a very small increased risk of cleft lip or cleft palate in the babies of mothers who took oral steroid medications during the first 13 weeks of pregnancy.

"Two studies found a slightly increased risk of premature delivery, and one study found a slightly increased risk of having a low birth weight baby.

"However, the researchers could not rule out the possibility that these effects were related to the woman's underlying medical condition rather than use of the drug."

In some research looking into the risks of prednisone during pregnancy, the small risk seen in general was not as great in women taking prednisone for IBD.

Oral Clefts

There is a very small risk of a cleft lip or palate in babies born to women who take prednisone during pregnancy, in particular when the prednisone is taken in the first trimester.

However, it is unknown how much of this risk could actually be due to the underlying chronic medical condition that the mother has for which she is taking prednisone and how much of it is from the actual drug.

Premature Delivery

Some studies have shown that pregnant women taking prednisone have a slight increase in delivering the baby early (preterm delivery).

One study in women with systemic lupus erythematosis (SLE or lupus)—an inflammatory disease in which the immune system attacks healthy tissues—showed that women with active lupus who took more than 10 milligrams of prednisone per day had an increased risk of preterm delivery.

However, one study of pregnant women with IBD showed that the medications used to treat IBD, such as prednisone, did not have any significant effect on preterm delivery.

Low Birth Weight

Some evidence suggests that prednisone during pregnancy may contribute to the risk of having a low birth weight baby.

However, the same study that showed no effect of IBD medications on preterm delivery also showed that IBD medications had no effect on birth weight.

A Word From Verywell

The evidence is somewhat conflicting, indicating that much is still unknown regarding the risks taking prednisone during pregnancy poses to an unborn baby.

However, most studies show the risks are low, and no studies on women with IBD have shown that prednisone presents a risk of major birth defects. Even so, it's recommended that you only use prednisone if it's clearly needed to treat your IBD.

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  1. Peppercorn Mark A. Inflammatory bowel disease and pregnancy. UpToDate. Updated October 2020.

  2. Bandoli G, Palmsten K, Forbess Smith CJ, Chambers CD. A review of systemic corticosteroid use in pregnancy and the risk of select pregnancy and birth outcomesRheum Dis Clin North Am. 2017;43(3):489–502. doi:10.1016/j.rdc.2017.04.013

  3. de Jesus GR, Mendoza-Pinto C, de Jesus NR, et al. Understanding and managing pregnancy in patients with lupusAutoimmune Dis. 2015;2015:943490. doi:10.1155/2015/943490

  4. MotherToBaby. Prednisone - Prednisolone. May 8, 2020.

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