The FDA has issued a warning to pregnant women about the possible miscarriage risk associated with taking an oral antifungal drug for yeast infections.

By Melissa Willets

A popular prescription drug women take for yeast infections may raise their miscarriage risk, according to a new U.S. Food and Drug Administration warning. This is big news, especially considering the fact that vaginal yeast infections are common during pregnancy, with approximately 10 percent of pregnant women in the U.S. developing one.

A 2016 study published in the Journal of the American Medical Association, analyzed more than 3,300 women who took the topical antigungal cream or oral drug flunconazole (Diflucan) in the 7th through 22nd week of pregnancy. Of the particpants, 147 had a miscarriage, compared with 563 miscarriages among the more than 13,000 women who did not take the drug, researchers found.

"From our study, we can only see that women who have been treated with oral fluconazole more often experience miscarriages than untreated women and women who used a topical [vaginal] antifungal," lead researcher Ditte Molgaard-Nielsen told HealthDay.

Molgaaard-Nielsen cautioned that the study cannot prove that fluconazole actually causes miscarriages, but said the research should not be ignored. "We cannot rule out that fluconazole-treated women differ from untreated women in ways that are associated with an increased risk of miscarriage," she said, adding that until more data are available on the association between fluconazole and the risk of miscarriage, the drug should be prescribed cautiously to pregnant women.

Dr. Jennifer Wu, an obstetrician and gynecologist at Lenox Hill Hospital in New York City, agrees. "Women who are trying to become pregnant or who are pregnant should avoid fluconazole," she said. "For these women, a topical medicine is the preferred treatment."

For the study, Molgaard-Nielsen and colleagues collected data on more than 1.4 million pregnancies from 1997 to 2013. They compared women who used oral fluconazole during pregnancy to those who didn't. The researchers also looked at the association between fluconazole and stillbirth, but found the drug did not significantly increase the risk of stillbirth.

"Patients who are pregnant or actively trying to get pregnant should talk to their healthcare professionals about alternative treatment options for yeast infections," cautions the FDA. So at what stage or stages of pregnancy is taking Diflucan risky? And how far in advance of trying to get pregnant should you avoid taking the oral medication? Unfortunately, more research is necessary before we'll know specifically how taking fluconazole can affect a pregnancy. For now, researchers are basing this warning on a Danish study that found a link between fluconazole and miscarriage, although it wasn't clear that the drug causes miscarriage.

It's important to note that according to Health Day, current labeling on oral fluconazole indicates a single 150 milligram (mg) dose is safe if taken during pregnancy. But until the FDA's review of the study is complete, the agency advises "cautious prescribing of oral fluconazole in pregnancy." And the CDC advises that pregnant women rely on topical medications to treat yeast infections.

Bottom line: If you're TTC or pregnant, and think you have a yeast infection, talk to your doctor.

Melissa Willets is a writer/blogger and a mom. Follow her on Twitter (@Spitupnsuburbs), where she chronicles her love of exercising and drinking coffee, but never simultaneously.



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