This sheet is about exposure to inhaled corticosteroids (ICSs) in pregnancy and while breastfeeding. This information is based on published research studies. It should not take the place of medical care and advice from your healthcare provider.
What are inhaled corticosteroids?
Inhaled corticosteroids (ICSs) are medications that have been used to prevent and control the symptoms of asthma. ICSs are taken using an inhaler, pump, or nebulizer. They go directly to the lungs instead of traveling throughout the body. ICSs help control the swelling of the airways in the lungs and reduce mucus production so that asthma attacks are less likely. Some examples of ICSs are beclomethasone dipropionate (Qvar®), budesonide (Pulmicort®), fluticasone propionate (Flovent®), mometasone furoate (Asmanex®), or triamcinolone acetonide (Azmacort®).
Sometimes when women find out they are pregnant, they think about changing how they take their medication, or stopping their medication altogether. However, it is important to talk with your healthcare providers before making any changes to how you take your medication. Your healthcare providers can talk with you about the benefits of treating your condition and the risks of untreated illness during pregnancy. For more information about asthma and pregnancy, see the MotherToBaby fact sheet at https://mothertobaby.org/fact-sheets/asthma-and-pregnancy/.
ICSs are considered preferred asthma treatments during pregnancy because they usually control asthma well. They are absorbed into the body in lower amounts compared to medication taken by mouth. It is unknown how much, if any, of the medication reaches the developing pregnancy. However, research suggests that the amount is likely small.
I take an ICS. Can it make it harder for me to get pregnant?
It is not known if ICSs can make it harder to get pregnant.
Does taking an ICS increase the chance of miscarriage?
Miscarriage is common and can occur in any pregnancy for many different reasons. There is some data to suggest that the use of ICSs might slightly increase the chance of miscarriage. However, that chance can be different depending on the exact medication. As there can be many causes of miscarriage, it is hard to know if a medication, the medical condition being treated, or other factors are the cause of a miscarriage.
Does taking an ICS increase the chance of birth defects?
Birth defects can happen in any pregnancy for different reasons. Out of all babies born each year, about 3 out of 100 (3%) will have a birth defect. We look at research studies to try to understand if an exposure, like an inhaled corticosteroid, might increase the chance of birth defects in a pregnancy. Studies that have been done on ICSs have found no overall increased chance of birth defects.
Does taking an ICS in pregnancy increase the chance of other pregnancy-related problems?
Studies on ICSs have found no increased chance of pregnancy-related problems, such as preterm delivery (birth before week 37) or low birth weight (weighing less than 5 pounds, 8 ounces [2500 grams] at birth).
Untreated asthma can cause low birth weight (weighing less than 5 pounds, 8 ounces [2500 grams] at birth) and other pregnancy complications. A recent study showed that treating asthma with ICSs might lower the chance of preterm delivery compared to untreated asthma. It is important to work with your healthcare provider to make sure your asthma is well-controlled during pregnancy.
Does taking an ICS in pregnancy affect future behavior or learning for the child?
It is not known if ICSs can increase the chance of behavior or learning issues for the child.
Breastfeeding while taking an ICS:
Most ICSs have not been studied for use during breastfeeding. However, the amount of medication that passes into breast milk following inhalation is likely small and not expected to cause problems for a breastfeeding infant. Be sure to talk to your healthcare provider about all your breastfeeding questions.
If a man takes an ICS, could it affect fertility or increase the chance of birth defects?
Studies have not been done to see if ICSs could affect men’s fertility (ability to get a woman pregnant) or increase the chance of birth defects. In general, exposures that fathers or sperm donors have are unlikely to increase risks to a pregnancy. For more information, please see the MotherToBaby fact sheet Paternal Exposures at https://mothertobaby.org/fact-sheets/paternal-exposures-pregnancy/.
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