Exposure to fluconazole and risk of congenital malformations in the offspring: A systematic review and meta-analysis

Vulvovaginal candidiasis (VVC) affects up to 75% of women at least once during their lifetime, mostly during the reproductive age, and recurrence rate is about 50%. Because half of all pregnancies are unplanned and pregnant women have an increased risk of VVC recurrence, the likelihood of inadverten...

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Published in:Reproductive toxicology (Elmsford, N.Y.) N.Y.), 2015-04, Vol.52, p.78-82
Main Authors: Alsaad, Abdulaziz M.S., Kaplan, Yusuf C., Koren, Gideon
Format: Article
Language:English
Subjects:
Abnormalities, Drug-Induced - epidemiology
Abnormalities, Drug-Induced - etiology
Antifungal Agents - adverse effects
Antifungal Agents - therapeutic use
Candidiasis, Vulvovaginal - drug therapy
Cardiovascular defects
Craniofacial Abnormalities - chemically induced
Craniofacial Abnormalities - epidemiology
Female
Fluconazole
Fluconazole - adverse effects
Heart Defects, Congenital - chemically induced
Heart Defects, Congenital - epidemiology
Humans
Infants
MEDLINE
Pregnancy
Pregnancy Trimester, First
Teratogenicity
Vulvovaginal candidiasis
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Summary:Vulvovaginal candidiasis (VVC) affects up to 75% of women at least once during their lifetime, mostly during the reproductive age, and recurrence rate is about 50%. Because half of all pregnancies are unplanned and pregnant women have an increased risk of VVC recurrence, the likelihood of inadvertently being exposed to fluconazole in pregnancy is increased. Thus, we aimed to examine the risk of congenital malformations in the offspring of women exposed to fluconazole in the first trimester of pregnancy. The rate for overall malformations was 1.10 (95% CI 0.98–1.25), for heart defect was 1.29 (95% CI 1.05–1.58), for craniofacial defects was 1.25 (95% CI 0.88–1.77), and for limb/musculoskeletal defects was 0.82 (95% CI 0.59–1.13). In conclusion, the use of fluconazole in the first trimester does not appear to increase the overall risk for congennital malformations. More studies are needed to address the potential increased rate of heart defects.
ISSN:0890-6238
1873-1708
DOI:10.1016/j.reprotox.2015.02.009