This sheet is about exposure to oral prednisone or prednisolone 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 prednisone and prednisolone?
Prednisone and prednisolone belong to a group of medications called corticosteroids. In the body, prednisone is broken down into prednisolone. Prednisone and prednisolone have been used to treat many conditions, such as asthma, autoimmune diseases, and skin conditions. They help prevent or suppress inflammation (swelling and irritation) and immune responses. Prednisone and prednisolone are prescribed in a wide range of doses, depending on what condition is being treated. For more information on asthma, see our fact sheet here: https://mothertobaby.org/fact-sheets/asthma-and-pregnancy/.
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.
I take prednisone or prednisolone. Can it make it harder for me to get pregnant?
Taking prednisone or prednisolone is not expected to make it harder to get pregnant.
Does prednisone or prednisolone increase the chance of miscarriage?
Miscarriage is common and can occur in any pregnancy for many different reasons. Taking prednisone or prednisolone is not expected to increase the chance of miscarriage. One study found that oral immunosuppressant medications, including prednisolone, might improve pregnancy outcomes in women with unexplained recurrent miscarriage (2 or more pregnancies that end in miscarriage) by lowering the chance of miscarriage.
Does prednisone or prednisolone 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 prednisone or prednisolone, might increase the chance of birth defects in a pregnancy.
Taking prednisone or prednisolone is not expected to greatly increase the chance of birth defects. Older studies suggested a very small possible increase in cleft lip and/or cleft palate (an opening in the upper lip or the roof of the mouth), when used in the first trimester. But newer studies and further review of the older studies have not confirmed this finding. If there is an increased risk, it appears to be very small, and most pregnancies would not be affected.
Does taking prednisone or prednisolone in pregnancy increase the chance of other pregnancy-related problems?
Taking an oral corticosteroid like prednisone or prednisolone long-term during pregnancy has been associated with an increased chance of preterm delivery (birth before week 37) and low birth weight (weighing less than 5 pounds, 8 ounces [2500 grams] at birth). However, it is hard to know whether these outcomes are related to the medications themselves or to the underlying medical conditions being treated. Conditions requiring corticosteroid treatment may also increase the chance of pregnancy complications. Other studies have shown that using prednisone or prednisolone might improve some pregnancy outcomes. The benefits of taking prednisone or prednisolone and treating your condition should be weighed against possible risks to the pregnancy.
Does taking prednisone or prednisolone in pregnancy affect future behavior or learning for the child?
A review of 14 studies found no consistent evidence that corticosteroid use during pregnancy increases the chance of learning, behavior, or developmental problems in children. Most outcomes showed no differences between exposed and unexposed children.
Breastfeeding while taking prednisone or prednisolone:
Prednisone and prednisolone get into breast milk in small amounts. Prednisone is like the body’s natural hormones that are needed for milk production. High doses can sometimes cause temporary loss of milk supply. There are reports of ~190 infants exposed to prednisone or prednisolone through breast milk with no reported side effects.
The amount of prednisone or prednisolone in breast milk might be higher in women taking higher doses. Waiting 4 hours after taking it before breastfeeding can also limit the amount of medication the baby gets in the breast milk. However, this is not necessary for everyone. Be sure to talk to your healthcare provider about all your breastfeeding questions.
If a man takes prednisone or prednisolone, could it affect his fertility or increase the chance of birth defects?
Small studies on men who had organ transplants and were being treated with medications that suppress the immune system (including prednisone and prednisolone) did not report lower rates of male fertility (ability to make healthy sperm). Studies have not been done to see if taking prednisone or prednisolone could increase the chance of birth defects. In general, exposures that men 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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