Prednisone, Pregnancy, Nursing: Decision Time


If you're considering continuing medication during pregnancy or nursing, chances are you need that drug. Chances are that without it, your quality of life will be severely impaired. Whether you need treatment for cancer, autoimmune diseases, asthma, allergies, lupus, colitis, arthritis, Still's disease, Bell's palsy, Chrohn's disease, pemphigus, sarcoidosis, kidney disease, mononucleosis, Epstein-Barr, organ transplant, migraines, or many others, choosing to go off your medication is always going to be a big decision. It doesn't make it any easier that the medical community hasn't reached a consensus on whether pregnant and nursing women should discontinue treatment. The best you can hope for is an informed doctor to assist in your decision-making process. Below, you will find specific information on the issues concerning this corticosteroid drug, pregnancy, and nursing.

Category C

Prednisolone, the active ingredient converted by the liver, is placed in pregnancy category C by the FDA. Pregnancy category C drugs have shown bad effects on fetuses using controlled animal reproduction studies. However, these drugs have not had adequate enough testing with human studies for the FDA to approve of or warn against usage. They note that category C medications may "warrant use" during pregnancy even when the dangers are taken into account.

So where does that leave you? Nowhere really. All that says is, "See if you think it's worth it." So, assuming you know the benefits of continuing medication, let's take a look at the risks.

Pregnancy

While there have not been any large studies on humans involving the FDA or meeting their standards, studies have shown that the risk of birth defects in non-human animal testing is elevated. Specifically, cleft palate may be a danger in human fetuses. This finding comes from four epidemiological studies, and one specific one in California, which showed a significant rise in the defect. However, there have been many similar studies which show no statistically significant results for any specific birth defect. The result is wide open for debate, but it seems as if there is not a danger clear enough to indict the drug, and that speaks volumes. You can see why it is pregnancy class C.

However, a Michigan study of birth defects notes that, using a database of 229,101 pregnancies from 1985 to 1992, the pregnancies in which the mother was exposed to prednisolone in the first trimester shows a "statistically significant increase" in birth defects on the whole. To be in line with the control group, there should have been six cases of birth defects. However, in actuality, there were eleven cases. To complicate matters further, there was no strong association between Prednisone, prednisolone, and any specific defect, such as cleft palate, in this study.

Nursing

Numerous tests have shown that the amount of Prednisone or prednisolone found in breast milk is at most trace. While no testing on human children has occurred, the science says that the amount found in breast milk should not be enough to cause any danger in human children. According to the American Academy of Pediatrics, Prednisone is compatible with breast feeding.