Prednisone is a corticosteroid medicine used to manage disorders such as asthma, irritable bowel syndrome (IBS), and some autoimmune diseases (1). However, you may be concerned about using prednisone during pregnancy due to the fear of adverse effects on the developing fetus. Therefore, it is important to inform your doctor if you are pregnant or planning to conceive when on this medication.
In this post, we explain whether prednisone is safe for pregnant women, when it is recommended for them, the recommended dosage, its possible side effects, and whether it causes withdrawal symptoms.
What Are Prednisone And Prednisolone?
Prednisone and prednisolone are synthetic corticosteroids, which work to suppress the inflammation and immune responses. Prednisone is broken down to prednisolone in the body, and both are helpful in treating autoimmune diseases, skin conditions and asthma. They mimic the activity of hydrocortisone, a natural corticosteroid produced by the adrenal glands.
They are suggested in different dosages based on the condition being treated and are available in the form of tablets, capsules, gels, inhalers, topical creams, eye drops, injections, and intravenous solutions (2).
Can You Take Prednisone During Pregnancy?
You can take prednisone during pregnancy only if its potential benefits are more than the risks to you and the baby. The US Food and Drug Administration (FDA) lists it under Pregnancy Category C of drugs, which means animal studies have shown adverse effects on the unborn baby, and there are no well-controlled studies in humans (3).
Prednisone is said to cross the placenta, but the fetal effect is minimized by a placental enzyme (11beta-hydroxysteroid dehydrogenase type 2) (4). However, you should take this drug only if your doctor prescribes it.
When Is Prednisone Recommended For Pregnant Women?
Your doctor would recommend the drug if the benefits outweigh the potential risks. It is prescribed in the case of:
- Autoimmune disorders including systemic lupus erythematosus (SLE), asthma, antiphospholipid syndrome and hepatitis.
- Severe allergic problems, where prednisone is prescribed in combination with other anti-allergic drugs (5).
- Hyperandrogenism, a condition of elevated male sex hormones in pregnant women. It happens when the fetus produces male hormones and enhances the androgen levels in the woman. This leads to decreased uterine tone and even pregnancy loss (6).
What Is The Recommended Dosage Of Prednisone For Pregnant Women?
The dosage of prednisone is different for different conditions. Your doctor might keep it under 20mg/day depending on the severity of the condition.
What Are The Possible Side Effects Of Prednisone During Pregnancy?
High dosage of prednisone is likely to cause some side effects as mentioned below:
- Studies found that the use of corticosteroids during pregnancy moderately increases the risk of cleft lip (7) (8).
- According to research, up to 70% of patients reported an increase in body weight due to prolonged use of the drug. Almost 73% of patients complained of sleep disorders (restlessness and insomnia) after taking this medication(9).
- Other common side effects include a headache, irritability, sleeplessness, nausea, weight gain, and anxiety. Serious side effects could be high blood sugar, changes in vision, swelling in the feet or ankles (10).
Does Prednisone Cause Withdrawal Symptoms?
Abrupt termination of the medication might result in general withdrawal symptoms such as weakness, extreme fatigue, diarrhea, slowed movements, fever, changes in skin color, salt cravings and weight loss. To avoid these, take the doctor’s advice before you reduce the dosage or stop the medication (10).
Is Prednisone Used In Infertility Treatment For Women With Repeated IVF Failure?
Corticosteroids such as prednisone are used to treat infertility in women as they are believed to reduce the number of natural killer cells to facilitate conception. But these drugs suppress the immune responses as well, preventing the immune system from responding to pregnancy. Suppression of the immune system will increase the risks of congenital disabilities, miscarriage and preterm labor (11).
Prednisone helps to manage asthma and autoimmune disorders. However, using prednisone during pregnancy might need caution as it may adversely affect your and your baby’s health. Experts suggest that prednisone should be used during pregnancy only when its benefits outweigh the risks. Therefore, if you are pregnant, inform your doctor about it and adjust the dosage of prednisone accordingly. Remember, taking the medication in a dose higher than recommended may cause cleft lip in babies and lead to sleep disorders, nausea, and headache in mothers.
This post is for informational purposes only and is not a replacement for a doctor’s consultation. Do not use any medication without talking to your doctor.
2. Drug record corticosteroids; National Institutes of Health; 2018
3. John J. Cush; Prevention and management of serious infections with biologic use in rheumatoid arthritis; Drug safety quarterly, 2013
4. W. Kemp, J.P. Newham, J.G. Challis, A.H Jobe, and S.J. Stock; ; Human Reproduction Update, Vol.22, No.2, pp. 240-259
5. Quick reference from the working group report on managing asthma during pregnancy: recommendations for pharmacologic treatment; National Asthma Education And Prevention Program; 2004
6. Deepti Jain; Fertility and pregnancy outcome in a woman with classic congenital adrenal hyperplasia; BMJ Case Rep; 2013
7. Gretchen Bandoli, et.al.; A review of systemic corticosteroid use in pregnancy and the risk of select pregnancy and birth outcomes; NCBI (2018)
8. Park W, Mazzotta P, et al.; Birth defects after maternal exposure to corticosteroids: prospective cohort study and meta-analysis of epidemiological studies; Teratology; 2000
9. Miriam C, Pasquale V; Corticosteroid-related central nervous system side effects; J PharmacolPharmacother; 2013
10. Prednisone; U.S. National Library of Medicine; 2015
11. Steroid treatment for IVF problems may do more harm than good; The University of Adelaide; 2016