Document Detail

Glucocorticoid therapy for rheumatic diseases: maternal, fetal, and breast-feeding considerations.
MedLine Citation:
PMID:  1285864     Owner:  NLM     Status:  MEDLINE    
Glucocorticoids form the mainstay of therapy for many rheumatic diseases, especially systemic lupus erythematosus (SLE). Prednisone is the drug of choice, because it has been well described during the pregnancy and is the primary drug for maintenance therapy or to induce a remission. Principles for prescribing glucocorticoids would apply during pregnancy, recognizing that many effects of rheumatic disease and long-term therapy are similar to physiologic changes of pregnancy. Particular attention should be placed on screening for pregnancy-induced glucose intolerance, hypertension, and delayed fetal growth. Although animal studies suggest an increased risk of oral clefts associated with glucocorticoids, several human studies have failed to demonstrate teratogenic or toxic effects. Nevertheless, rare cases of transient fetal adrenal suppression have been reported, so all infants should be monitored in the nursery. Breast-feeding is safe, with clinically insignificant amounts of the drug being concentrated in breast milk.
W F Rayburn
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  American journal of reproductive immunology (New York, N.Y. : 1989)     Volume:  28     ISSN:  1046-7408     ISO Abbreviation:  Am. J. Reprod. Immunol.     Publication Date:    1992 Oct-Dec
Date Detail:
Created Date:  1993-03-18     Completed Date:  1993-03-18     Revised Date:  2005-11-16    
Medline Journal Info:
Nlm Unique ID:  8912860     Medline TA:  Am J Reprod Immunol     Country:  DENMARK    
Other Details:
Languages:  eng     Pagination:  138-40     Citation Subset:  IM    
Department of Obstetrics and Gynecology, University of Oklahoma Health Science Center, Oklahoma City.
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MeSH Terms
Fetal Growth Retardation / chemically induced
Fetus / drug effects
Glucocorticoids / adverse effects,  therapeutic use*
Maternal-Fetal Exchange
Pregnancy Complications / drug therapy*
Rheumatic Diseases / drug therapy*
Reg. No./Substance:

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