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Desloratadine use in pregnancy was not associated with fetal risk

Published online: March 3, 2020

Desloratadine is a commonly used antihistamine for the treatment of allergic disorders, which often also require treatment during pregnancy. However, data to support the safety for the fetus of desloratadine use during pregnancy are lacking, and no previous studies have examined this issue. Current guidelines recommend use of loratadine or cetirizine in pregnancy when treatment with antihistamines are required in pregnancy.

The Journal of Allergy and Clinical Immunology: In Practice published a nationwide registry-based cohort study conducted by Andersson et al, which included all pregnancies in Denmark with use of desloratadine in pregnancy during the study period from 2001 through 2016. The associated risk of adverse fetal outcomes of desloratadine use in pregnancy was compared with pregnancies with loratadine use as well as compared with cetirizine use and with pregnancies with prior recent use of desloratadine but not in pregnancy. Up to a total of 3388 pregnancies with use of desloratadine were included in the study cohorts (the exact sample size depending on the specific outcome analysis). The adverse fetal outcomes assessed were major birth defects, spontaneous abortion, preterm birth, small size for gestational age, and stillbirth. A wide set of potential confounders were controlled for by use of propensity score matching.

These study results were not suggestive of an association between desloratadine use in pregnancy and an increased risk of adverse fetal outcomes, including major birth defects, spontaneous abortion, preterm birth, small size for gestational age, and stillbirth. As such these findings provide reassurance by indicating that the fetal safety of desloratadine is similar to the currently recommended antihistamines during pregnancy and thus desloratadine can be considered to be another option for use during pregnancy.

The Journal of Allergy and Clinical Immunology: In Practice is an official journal of the AAAAI, focusing on practical information for the practicing clinician.

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