Should I take prednisone if I have never had a miscarriage or have never been pregnant?

Patient

Q: I am about 5 weeks pregnant and have been advised by my fertility doctor to begin taking 5mg of prednisone 1 daily.
I have NEVER had any miscarriages, nor have I ever been pregnant.
I am a bit hesitant as I know there are some possible side effects with prednisone. The nurse that called me advised me that my doctor said she was recommending I take prednisone based on some blood test I had done within the last year that show something about a possible autoimmune disorder.
I guess I am concerned because I have done some research on prednisone while pregnant but I find most women that are on it have had miscarriages in the past.
I feel I would rather wait and hope to not to have a miscarriage, then put a possibly healthy embryo at slight risk. If I were to have a miscarriage, then I would definitely consider the auto immune disorder and make a decision to take the medication at that point.
Don't know what to do.

Doctor

A:   Thank you for your question. There are some risks associated with taking any corticosteroid medication such as prednisone during pregnancy. During the first trimester of pregnancy there is a minor risk of cleft palate and lip if the child is exposed to prednisone. Furthermore, taking prednisone daily during pregnancy can pose a risk of premature delivery. These risks are very minor and they are generally not something to be concerned with. Especially if your fertility specialist has advised you to take this medication to suppress a possible autoimmune disorder which can pose a risk to your pregnancy. Having said that, you have a right to a second opinion, as well as not to take any medications you do not feel comfortable with. We are not certain what the lab value was that lead your doctor to prescribe you prednisone, so we cannot advise you in detail on this. We recommend that you follow up with your fertility doctor and question the necessity for taking this medication. If you are not satisfied, you are more than welcome to consult another specialist or send us a follow up question, once you have more specific details based on your lab results and reason for being prescribed prednisone.

We look forward to your response. Thank you for choosing AskTheDoctor.com

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