Use of oral antifungal medication during pregnancy, risk of spontaneous abortion

In an analysis of approximately 1.4 million pregnancies in Denmark, use of the oral antifungal medication fluconazole during pregnancy was associated with an increased risk of spontaneous abortion compared with risk among unexposed women and women who used a topical antifungal during pregnancy, according to a study in the January 5 issue of JAMA. Pregnant women are at increased risk of vaginal candidiasis (yeast infection); the prevalence of vaginal candidiasis among pregnant women is estimated to be 10 percent in the United States.

Although intravaginal formulations of topical azole antifungals are the first-line treatment for pregnant women, oral fluconazole is often used despite limited safety information. Ditte Molgaard-Nielsen, M.Sc, of the Statens Serum Institut, Copenhagen, Denmark, and colleagues evaluated the association between oral fluconazole exposure during pregnancy and…