Yeast Infection Treatment Tied to Miscarriage Risk
The oral drug fluconazole may increase the risk, Danish researchers say
By Steven Reinberg
TUESDAY, Jan. 5, 2016 (HealthDay News) -- A well-known antifungal drug used for vaginal yeast infections may be linked to a slightly increased risk of miscarriage, according to a study of more than 1.4 million Danish pregnancies.
Of the more than 3,300 women who took oral fluconazole (Diflucan) in the 7th through 22nd week of pregnancy, 147 had a miscarriage, compared with 563 miscarriages among the more than 13,000 women who did not take the drug, the researchers found.
"From our study, we can only see that women who have been treated with oral fluconazole more often experience miscarriages than untreated women and women who used a topical [vaginal] antifungal," said lead researcher Ditte Molgaard-Nielsen, an epidemiologist at the Statens Serum Institute in Copenhagen.
However, the study cannot prove that fluconazole causes miscarriages, she added.
"Our findings cannot precisely show whether fluconazole causes miscarriage. We cannot rule out that fluconazole-treated women differ from untreated women in ways that are associated with an increased risk of miscarriage," Molgaard-Nielsen said.
She added that until more data are available on the association between fluconazole and the risk of miscarriage, the drug should be prescribed cautiously to pregnant women.
The report was published in the Jan. 5 issue of the Journal of the American Medical Association.
Vaginal yeast infections are common during pregnancy. In the United States, it is estimated that 10 percent of pregnant women will develop one. Treatment is either a topical antifungal cream or the oral drug fluconazole, Molgaard-Nielsen said.
"Topical antifungals (vaginal suppositories) are first-line treatment for pregnant women, but a small number of pregnant women receive oral treatment with fluconazole, for example in cases of recurrence, severe symptoms, or when topical treatment fails. But oral fluconazole may also be used as first treatment by personal preference," she said.
Dr. Jennifer Wu, an obstetrician and gynecologist at Lenox Hill Hospital in New York City, said that fluconazole is the only oral drug used to treat yeast infections.
"Women who are trying to become pregnant or who are pregnant should avoid fluconazole," Wu said. "For these women, a topical medicine is the preferred treatment."