Prenatal exposure to oral glucocorticoids may slightly increase the risk of children developing mental health conditions later in life, according to a new study published in the Journal of the American Medical Association (JAMA) Psychiatry.
The 2025 study notes that risks associated with prenatal exposure to these medications, which are commonly prescribed to treat autoimmune conditions like inflammatory bowel disease and rheumatoid arthritis, include intellectual disorders, attention-deficit/hyperactivity disorder (ADHD), autism, and anxiety.
While the difference in risk between children exposed to these drugs and those who weren’t was “low to moderate,” doctors “need to be certain that the medication is really necessary when prescribing it to pregnant women,” says Kristina Laugesen, M.D., Ph.D., a clinical epidemiologist at Aarhus University in Denmark and lead author of the study.
What Are Glucocorticoids?
Glucocorticoids, also frequently called corticosteroids, are medications designed to suppress inflammation or an overactive immune system that mistakenly attacks healthy tissues. They are often used to treat a variety of inflammatory, allergic, and autoimmune conditions, such as lupus and Crohn’s disease.
Examples of commonly prescribed glucocorticoids include:
- Prednisone
- Methylprednisolone
- Dexamethasone
- Hydrocortisone
- Betamethasone
Glucocorticoids in Pregnancy: Key Findings from the Latest Study
Research has pointed to the possibility that prenatal exposure to these medications might raise the risk of some mental disorders in children. But, because the steroids were given in cases of preterm labor and underlying maternal disease, it has been unclear whether the risk came from the steroids themselves or the underlying conditions they were treating.
In the new study, Dr. Laugesen and her team reviewed the medical records from the Danish national registry of 1,061,548 infants born between 1999 and 2016. At the time of the study, most of the children were between 7 and 14 years old.
A major strength of the study is that Dr. Laugesen and her team matched mothers who took glucocorticoids during pregnancy with those who had similar autoimmune conditions or risks of preterm birth but did not take them. This approach created a stronger control group, which allowed the scientists to do more specific comparisons and better isolate the effects of the drugs from the impact of the underlying health conditions.
Still, researchers were not able to control who received the steroids, and it’s possible that those mothers with more severe disease or a higher risk of preterm delivery were more likely to have taken them, meaning that those conditions might have played a role in the child’s brain development.
Children exposed to glucocorticoids prenatally were found to have significantly higher rates of autism spectrum disorders (ASDs), ADHD, and mood, anxiety or stress-related disorders than those born to mothers with similar conditions but who were not taking glucocorticoids. The results were listed as follows:
- 4.8% of those children prenatally exposed to glucocorticoids were diagnosed with ASDs, compared to 3.8% of those who were not exposed. Thus, exposed infants were 30% more likely to develop ASDs.
- 1.1% of those exposed to glucocorticoids were diagnosed with intellectual disabilities, compared to 0.8% of those who were not exposed. However, even though this finding was higher, it was not statistically significant.
- 5.5% of those who were exposed to glucocorticoids were diagnosed with ADHD, compared to 4.4% of those who were not exposed. These results were found to have borderline significance, meaning there was not a very strong association.
- 6.6% of those who were exposed to glucocorticoids were diagnosed with mood, anxiety and stress-related disorders, compared to 4.6% of those who were not exposed, making them 40% more likely to develop these conditions.
How to Talk to Your Doctor About Glucocorticoids in Pregnancy
“It’s important to highlight that glucocorticoids have many beneficial effects,” says Dr. Laugesen.
If you’re taking glucocorticoids and become pregnant or hope to become pregnant, ask your healthcare provider the following questions:
- What will happen if I stop taking glucocorticoids?
- How will I feel if I stop taking them?
- What are the benefits of continuing to take them?
- What risk does my condition present to my baby, with and without the steroids?
- If I want to stop taking them, do I need to taper off, or can I immediately discontinue them?
Dr. Laugesen hopes that the findings from this study will inspire more research about predicting the risk of preterm birth and the safety of alternative medications for women with autoimmune and inflammatory disorders. In the meantime, she says that while it’s important to ask healthcare providers about individual risks, “we would like to emphasize that women should not stop taking their prescribed medication.”
Stopping glucocorticoids abruptly can cause withdrawal symptoms such as fevers, anorexia, nausea, fatigue, joint pain and more. It’s important to work with your prescriber to plan the best way to discontinue or taper these medications safely.
