The risks of topical ophthalmic corticosteroids during pregnancy remain unclear. We investigated the association between exposure to topical ophthalmic corticosteroids during pregnancy and adverse neonatal outcomes.
Retrospective, cohort, database study.
Pregnant women with allergic conjunctivitis in the JMDC Claims Database (JMDC Inc., Japan) between 2005 and 2018 were included. We compared adverse neonatal outcomes (congenital anomalies [CA], preterm birth [PB], low birthweight [LB], and the composite outcome of these three) between mothers with and withouttopical ophthalmic corticosteroids during the first trimester. Controls were women who were not prescribed topical ophthalmic corticosteroids during the first trimester. We first calculated propensity scores with known confounders, including disorders during pregnancy, other chronic comorbidities, and use of antihistamines. We then conducted logistic regression with propensity-score adjustment.
We identified 6847 eligible women of whom 898 (13%) had received topical ophthalmic corticosteroids. CA occurred in 5.5% and 4.9%, PB in 3.4% and 3.9%, LB in 5.9% and 7.0%, and the composite outcome in 11.7% and 11.7% of exposed and unexposed mothers, respectively. Corticosteroid eye drops were not significantly associated with an increase in CA (adjusted odds ratio [aOR], 0.78; 95% confidence interval [CI], 0.54-1.14; P = 0.20), PB (aOR, 1.23; 95%CI,0.80-1.88; P = 0.35), LB (aOR, 1.17; 95%CI, 0.84-1.61; P = 0.35), or composite outcome (aOR, 0.95; 95%CI, 0.73-1.22; P = 0.68).
The use of topical ophthalmic corticosteroids in pregnant women with allergic conjunctivitis was not associated with any increase in CA, PB, or LB.

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