[Maternal corticotherapy . Pharmacology and effect on the fetus]

There are many indications for steroids in pregnant women including asthma, chronic inflammatory diseases and disseminated lupus erythematosus. Prednisone and prednisolone, the preferred drugs, are inactivated by the placenta so that fetal exposure is minimal. The effect of corticosteroids on the fetus has been studied by a number of workers. The earliest studies in the sixties reported various adverse effects (prematurity, intra-uterine growth retardation), but cannot always be used to analyze the effect of steroid drugs, often used at uneffective doses versus that of the underlying pathology. In the more recent studies conducted since 1980, steroids were given at effective doses and show that maternal-targeted corticosteroids are more beneficial than detrimental for the fetus. Indeed, steroid drugs have no teratogenic effect in man and carry no risk of fetal intoxication at therapeutic doses. The long-term risk remains to be evaluated.