medication for yeast infection during pregnancy

A recent study has examined whether oral medication for yeast infection during pregnancy may be linked to birth defects in the developing fetus.

The vagina contains a balanced mix of yeast and bacteria such as lactobacillus.  However, that balance can be disturbed and lead to a yeast infection. Vaginal yeast infections are caused by Candida albicans, which is a fungus that affects up to 75% of women at some point in their life Yeast infections are common in pregnant women because they have higher estrogen levels. Oral medication is used when topical treatments, such as creams and gels, fail.

The safety of oral medication for yeast infection during pregnancy is controversial

In a recent study published in the International Journal of Gynaecology and Obstetrics, researchers assessed the risk of adverse fetal outcomes after exposure to oral antifungal agents during pregnancy by examining published research on the subject. The medications for yeast infection during pregnancy that were investigated were fluconazole and itraconazole. The previous studies found that Fluconazole can increase the risk of congenital heart defects and limb defects while itraconazole can increase the risk of eye defects.  For fluconazole, congenital heart defects were at a frequency of 1.52% and limb defects were at a frequency of 0.62%.  When the pregnancy women used itraconazole, the frequency of eye defects was 0.56%.

Treatment was not associated with an increase in overall birth defects

When analyzing all published evidence, the researchers found that treatment with fluconazole and itraconazole did not increase the risk of overall birth defects but instead may increase the risk of specific birth defects. The data collected was for the first trimester of pregnancy which is the time when the fetus is most sensitive to birth defects. They also found that fluconazole and itraconazole did not increase the risk of spontaneous abortion or stillbirths. A significant insufficiency in the data derived from this study was the lack of reported specific dosages used during treatment.

The researchers suggest that further research regarding the risk of congenital heart defects and limb defects from fluconazole, and eye defects from itraconazole, should be investigated further.

 

Written by Katrina F. Zafer, BSc

 

References:

  1. Liu, D., Zhang, C., Wu, L., Zhang, L., Zhang, L. (2019)  Fetal outcomes after maternal exposure to oral antifungal agents during pregnancy: A systematic review and meta-analysis. International Journal of Gynecology and Obstetricshttps://doi.org/10.1002/ijgo.12993
  2. News release – Are oral medications for vaginal yeast infections safe during pregnancy?  https://www.eurekalert.org/pub_releases/2019-11/w-aom110519.php
  3. The Mayo Clinic.  https://www.mayoclinic.org/diseases-conditions/yeast-infection/symptoms-causes/syc-20378999

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