Nav: Home

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

January 05, 2016

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 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 the risk of spontaneous abortion and stillbirth. The study included 1,405,663 pregnancies in Denmark from 1997-2013. From this group, oral fluconazole-exposed pregnancies were compared with up to 4 unexposed pregnancies, matched on maternal age, calendar year, and gestational age. Filled prescriptions for oral fluconazole were obtained from the National Prescription Register.

Among 3,315 women exposed to oral fluconazole from 7 through 22 weeks' gestation, 147 experienced a spontaneous abortion, compared with 563 among 13,246 unexposed matched women (women not exposed to antifungals). There was a significantly increased risk of spontaneous abortion associated with fluconazole exposure. Among 5,382 women exposed to fluconazole from gestational week 7 to birth, 21 experienced a stillbirth, compared with 77 among 21,506 unexposed matched women. There was no significant association between fluconazole exposure and stillbirth. Using topical azole exposure as a comparison, 130 of 2,823 women exposed to fluconazole vs 118 of 2,823 exposed to topical azoles had a spontaneous abortion; 20 of 4,301 women exposed to fluconazole vs 22 of 4,301 exposed to topical azoles had a stillbirth.

"In this nationwide cohort in Denmark, oral fluconazole use in pregnancy was associated with a significantly increased risk of spontaneous abortion," the authors write. "Until more data on the association are available, cautious prescribing of fluconazole in pregnancy may be advisable. Although the risk of stillbirth was not significantly increased, this outcome should be investigated further."
-end-
(doi:10.1001/jama.2015.17844; Available pre-embargo to the media at http://media.jamanetwork.com)

Editor's Note: This study was supported by the Danish Medical Research Council. All authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest and none were reported.

The JAMA Network Journals

Related Pregnancy Articles:

Going to sleep on your back in late pregnancy
This study looked at whether going to sleep on your back in the third trimester of pregnancy was associated with average lower birth weights.
Opioid use disorder in pregnancy: 5 things to know
Opioid use is increasing in pregnancy as well as the general population.
Medical imaging rates during pregnancy
Researchers looked at rates of medical imaging (CT, MRI, conventional x-rays, angiography, fluoroscopy and nuclear medicine) during pregnancy in this observational study that included nearly 3.5 million pregnant women in the United States and Canada from 1996 to 2016.
New research on diet and supplements during pregnancy and beyond
The foods and nutrients a woman consumes while pregnant have important health implications for her and her baby.
Obesity in early pregnancy linked to pregnancy complications
In a prospective study published in Obesity of 18,481 pregnant women in China who had never given birth before, obesity in early pregnancy was linked to higher risks of spontaneous abortion, preterm birth, and large birth weight in newborns.
More Pregnancy News and Pregnancy Current Events

Best Science Podcasts 2019

We have hand picked the best science podcasts for 2019. Sit back and enjoy new science podcasts updated daily from your favorite science news services and scientists.
Now Playing: TED Radio Hour

Rethinking Anger
Anger is universal and complex: it can be quiet, festering, justified, vengeful, and destructive. This hour, TED speakers explore the many sides of anger, why we need it, and who's allowed to feel it. Guests include psychologists Ryan Martin and Russell Kolts, writer Soraya Chemaly, former talk radio host Lisa Fritsch, and business professor Dan Moshavi.
Now Playing: Science for the People

#537 Science Journalism, Hold the Hype
Everyone's seen a piece of science getting over-exaggerated in the media. Most people would be quick to blame journalists and big media for getting in wrong. In many cases, you'd be right. But there's other sources of hype in science journalism. and one of them can be found in the humble, and little-known press release. We're talking with Chris Chambers about doing science about science journalism, and where the hype creeps in. Related links: The association between exaggeration in health related science news and academic press releases: retrospective observational study Claims of causality in health news: a randomised trial This...