Study: Oral antifungal drug raises risk of miscarriage

A new study has found that the common oral antifungal drug fluconazole may be linked with a higher risk of miscarriage during pregnancy. (AFP Relax pic)

MONTREAL: New Canadian research has found that fluconazole, a medication commonly used to treat vaginal yeast infections, may increase the risk of miscarriage if used during pregnancy.

Carried out by researchers at the University of Montreal, the new study looked at data on 441,949 pregnancies taken from the Quebec Pregnancy Cohort.

The researchers then linked the data with filled prescriptions for oral fluconazole listed in the Quebec Prescription Drug Insurance database, looking at the effect of exposure to both high (> 150 mg) and low (≤ 150 mg) doses of fluconazole during pregnancy on the risk of miscarriage, major congenital malformations and stillbirths.

The findings, published in Canadian Medical Association Journal, showed that taking oral fluconazole at any dose was linked to an increased risk of miscarriage compared to not taking fluconazole.

Although taking fluconazole during the first trimester was not linked with an increased risk of major congenital malformations, taking higher doses of the medication during this time was linked to higher chance of babies being born with a heart defect.

No association was found between exposure to fluconazole during pregnancy and the risk of stillbirth.

The researchers note that around 10% of pregnant women are affected by the common yeast infection vulvovaginal candidiasis, and although topical treatments are recommended as the first line treatment, low-doses of oral fluconazole are often used during pregnancy.

The researchers also add that the findings are in line with those from previous studies, although they note that as the sample sizes used in these studies were small, further research is still needed.

Drs Vanessa Paquette and Chelsea Elwood from British Columbia Women’s Hospital and Health Centre commented on the findings in a related article, saying “The study re-emphasises safe prescribing practices in pregnancy, which include confirming the correct diagnosis and then choosing the safest medication with the largest body of data in pregnancy at the lowest appropriate doses.”