While treatment for allergic conjunctivitis isn’t essential in pregnant women because it is rarely a vision-threatening disease, many would like some relief from the symptoms. Now, researchers in Tokyo have determined that the use of ophthalmic corticosteroids during the first trimester was not associated with any adverse effects on the baby, including congenital anomalies, preterm birth, low birth weight and composite outcome. The researchers note that their results will be valuable for clinicians trying to decide whether to prescribe ophthalmic corticosteroids to pregnant women suffering from the condition.

When comparing 898 pregnant females who received topical ophthalmic corticosteroids with mothers not prescribed steroids in the first trimester, the study found congenital anomalies occurred in 5.5% and 4.9%, preterm birth in 3.4% and 3.9%, low birth weight in 5.9% and 7.0% and the composite outcome of the three in 11.7% and 11.7%, respectively. The researchers then calculated propensity scores with known confounders, including disorders during pregnancy, other chronic comorbidities and use of antihistamines.

No significant association between corticosteroid eye drops was found with an increase in any of the adverse outcomes. The most frequently and second-most frequently prescribed medications in the current study were fluorometholone 0.1% and betamethasone 0.1%, respectively, with the highest concentration of 0.1% prescribed more frequently than lower concentrations.

Hasimoto Y, Michihata N, Yamana H, et al. Ophthalmic corticosteroids in pregnant women with allergic conjunctivitis and adverse neonatal outcomes: propensity score analyses. Am J Ophthalmol. July 16, 2020. [Epub ahead of print].