Can You Take Prednisone While Pregnant?

Pregnant woman taking multi-vitamins
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One of the chief concerns of pregnant women with inflammatory bowel disease (IBD) is the effect that the medications to treat IBD may have on an unborn baby. For example, oral steroids such as prednisone are commonly used to treat IBD, and they carry the potential for a host of side effects. Naturally, women with IBD and other inflammatory conditions are going to have questions about taking prednisone during pregnancy.

Managing IBD During Pregnancy

In many cases, medications are clearly needed for pregnant women who have chronic conditions—for the health of both the mother and the baby. If medications like prednisone (corticosteroids) are being recommended by doctors, it means that the risks of the drugs are going to be lower than the risks of not taking any medications.

For women with IBD, it is going to be 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, there are still many good medication options that can help control IBD inflammation for a pregnant mother. Reducing inflammation from IBD and protecting the baby are going to be the key factors in ensuring as healthy a pregnancy as possible.

How Prednisone Affects Babies

To find out more about prednisone during pregnancy and, in particular, any effects this medication might have on an unborn baby, I turned to UpToDate, a resource for physicians and patients looking for in-depth medical information.

"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."

Prednisone during pregnancy has been associated with cleft lip or palate, premature delivery, and low birth weight. These risks appear to be small, however, and in women with IBD, evidence shows that major birth defects are not likely.

What This Means for Women With IBD

Research has looked into the risks of prednisone during pregnancy, and in some studies, 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),—an inflammatory disease, also known as lupus, in which the immune system attacks its own tissues—showed that women whose lupus was active and who also took more than 10 mg 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

There is some evidence 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 that 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 is recommended that prednisone only be used in cases where it is clearly needed to treat the mother's IBD.

It's important to note that it is potentially dangerous to stop taking prednisone abruptly. Talking to a doctor about any concerns is the best course of action. The decision to discontinue taking the medication should be made with the consultation of an obstetrician and a gastroenterologist, preferably one who specializes in IBD and pregnancy.

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Article Sources
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  1. Peppercorn MD, Mahadevan U. Patient education: Inflammatory bowel disease and pregnancy (Beyond the Basics). UpToDate (online). 2019.

  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. Prednisone Fact Sheet. MotherToBaby (online). 2018.

Additional Reading
  • Huang VW, Chang HJ, Kroeker KI, et al. "Management of Inflammatory Bowel Disease during Pregnancy and Breastfeeding Varies Widely: A Need for Further Education." Can J Gastroenterol Hepatol. 2016;2016:6193275.
  • Peppercorn Mark A. "Inflammatory bowel disease and pregnancy." UpToDate. 12 May 2016.