Higher rates of miscarriage could be caused by oral antifungal drug

Higher rates of miscarriage could be caused by oral antifungal drug
© iStock/Shidlovski

Published in CMAJ, new research has found that oral antifungal drug used to treat yeast infections is linked to higher rates of miscarriage.

A commonly used oral antifungal drug, fluconazole, used to treat vaginal yeast infections, has found to be linked to higher rates of miscarriage if used during pregnancy.

What do you know about oral antifungal drugs?

As described by NHS England, antifungal medicines work by either killing the fungal cells – for example, by affecting a substance in the cell walls, causing the contents of the fungal cells to leak out and the cells to die or preventing the fungal cells growing and reproducing.

While topical treatments are first line for pregnant women with fungal infections, oral fluconazole is often used during pregnancy.

Details of the study

Researchers looked at data on 441,949 pregnancies from the Quebec Pregnancy Cohort between 1998 and 2015, linking to filled prescriptions listed in the Quebec Prescription Drug Insurance database, Canada.

They discovered that taking oral fluconazole was linked to adverse outcomes.

Dr. Anick Bérard, Université de Montréal, Canada, explained: “Our study shows that taking any dose of oral fluconazole while pregnant may be associated with a higher chance of miscarriage.”

“Taking higher doses of fluconazole over 150 mg in early pregnancy may be linked to a higher chance of a new born with a heart defect.”

In a related commentary, Dr. Vanessa Paquette and Dr. Chelsea Elwood, British Columbia Women’s Hospital and Health Centre, Vancouver, Canada, write: “The study re-emphasizes 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.”

Further studies required

According to the researchers, the study is consistent with other studies of linking antifungal drugs to adverse birth outcomes, however more research is needed as the study sizes are still small.

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