Pemphigoid gestationis

To our knowledge, there is no data on the long-term prognosis for children of mothers who had pemphigoid gestationis (PG).^[1] Hence, we are not aware of any data regarding whether PG might affect fertility in the offspring of affected women. We are only aware of information about potential effects of PG on the fetus and the newborn.

PG is associated with an increased risk of premature birth, and being small-for-gestational-age.^[2] To our knowledge, no specific congenital abnormalities have been linked to PG. While the IgG antibodies present with PG do pass through the placenta, only about 3% of newborn infants develop PG blisters. However, skin symptoms in newborns usually resolve quickly without treatment as the antibody levels decrease. If the mother was treated with large doses of cortisone, there is a possibility of neonatal adrenal insufficiency to occur.^[1]

Taking an oral corticosteroid like prednisone long-term during pregnancy has been associated with an increased chance for delivering a baby that is premature (born before 37 weeks of pregnancy) and/or has a lower birth weight than expected.^[3]

Older studies have suggested a small increased chance of oral clefts when oral corticosteroids like prednisone are used in the first trimester. However, a number of other studies have not shown an increase in the chance for birth defects (including oral clefts) with first trimester exposure.^[3] If there is a risk from first trimester exposure to prednisone, it is thought to be very small.^[3]

There have also been concerns that some of the toxicity associated with glucocorticoids in adults might affect exposed fetuses. However, long-term follow-up of children of mothers who received prednisone as an immunosuppressant during pregnancy did not identify adverse physical, immunologic, or neurodevelopmental effects of exposure. A follow-up study in pre-pubertal children of mothers receiving prednisone during pregnancy found higher daytime cortisol concentrations in the children, but no associated adverse effects.^[4] To our knowledge, no effects on fertility in humans has been reported.

Women who are pregnant, or planning to become pregnant, should speak with their healthcare provider about their treatment plan. In many cases, the decision to begin or continue a medication during pregnancy is made on a case-by-case basis, after careful consideration of the benefits and risks.

When a condition is rare, there is often little information in the literature and it can be difficult to find someone who has seen many cases. We encourage you to view our fact sheet How to Find a Disease Specialist, which provides strategies for identifying healthcare professionals and/or researchers who have experience with a particular condition.