There are a number of therapies that your doctor can prescribe to you if you and your baby are found to be at risk of fetal and neonatal alloimmune thrombocytopenia (FNAIT)
Prednisone, a corticosteroid, is one such therapy. Here is why it is sometimes prescribed, what it does, and what the risks are of prolonged usage.
Prednisone has immunosuppressive properties
The primary use of prednisone in any disease is to suppress the immune response and to reduce inflammation. This is why it is widely used in autoimmune and inflammatory disorders, such as rheumatoid arthritis and inflammatory bowel disease.
In FNAIT, the main medical problem is that the mother’s immune system behaves in a way that it should not in that it produces antibodies that harm the fetus. This dysregulation of the maternal immune system is what causes it to attack fetal platelets, causing the fetus to lack these cells that are vital for the their safety and protection.
Read more about FNAIT testing and diagnosis
Prednisone is prescribed to suppress the maternal immune system to stop this from happening. By putting the brakes on the maternal immune system’s ability to destroy fetal platelets, doctors are able to minimize the risk of complications to the fetus, especially while still in the womb.
Prednisone is an oral medication and therefore does not require any injections. This is an advantage, because any invasive treatment during pregnancy risks harm to the mother and the fetus. Furthermore, prednisone is a relatively inexpensive medication and is widely accessible in most parts of the world.
Side effects of prednisone
Like all drugs, prednisone has some side effects. Because it acts as a damper on the maternal immune system, there is a risk that it impairs the ability of the maternal immune system to defend itself against diseases, such as infections. If a pregnant woman becomes sick, it might complicate the course of her pregnancy.
Prednisone can also cause a number of well-documented complications, such as weight gain, acne, thinning of the hair and skin, and mood swings. The risk of these complications increases the longer you’re on prednisone. This is why doctors try not to prescribe prednisone for the long-term because at least some of these complications are bound to arise during prolonged usage. Typically, doctors prescribe prednisone for a short period of time for maximal impact before switching the patient to an alternative medication.
However, if you’re being given prednisone for FNAIT, you’re unlikely to be on it for very long because FNAIT is an issue of pregnancy; once the baby is delivered, the problem is over on your end because there are no longer fetal platelets for the immune system to act against. Instead, attention turns towards your child to ensure that your child’s platelet levels are boosted and that bleeding complications do not occur.
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