Drug to treat yeast infection tied to increased risk of miscarriage

Because of hormonal changes that occur during pregnancy, pregnant women have a heightened risk of vaginal candidiasis – also known as yeast infections.

The first-line treatment for pregnant women are usually intravaginal topical creams or "tablets", but in some cases, oral medications are prescribed as well.

But now a large Danish study, recently published in Journal of the American Medical Association, has revealed that a common prescription oral drug used to treat yeast infections may increase the risk of miscarriages if taken during the early stages of pregnancy. The study, conducted over 17 years between 1997 and 2013 at the Statens Serum Institut in Denmark, saw scientists examine the effects of oral versions of fluconazole on a whopping 1.4 million pregnancies.

Fluconazole is available in generic versions and under the brand name Diflucan, typically prescribed in a single dose, and for stubborn infections, sometimes women are prescribed multiple high doses of the drug.

To conduct the study, the scientist in Denmark matched the pregnancies on maternal age, calendar year and gestational age, and oral fluconazole-exposed pregnancies from that group were compared with up to four unexposed pregnancies.

The results of the lengthy study were, to put it mildly, rather disturbing, with numbers showing that Danish women who used the drug during the first six months of their pregnancies were nearly 50 percent more likely to suffer a miscarriage than non-users.

Of 3,315 women exposed to oral fluconazole from seven through 22 weeks gestation, 147 experienced a spontaneous abortion. Comparatively, 563 of 13,246 of the matched women who weren’t exposed to antifungals experienced miscarriages.

Women who were at increased risk included those on a low 150-milligram dose, according to the study authors, and those on higher doses faced greater miscarriage risks, the study found.

According to the study authors, doctors should use extreme caution when prescribing oral fluconazole early in pregnancy, and urged for more research into the drug to be done.