Are oral medications for vaginal yeast infections safe during pregnancy?

Vaginal yeast infections may occur more commonly during pregnancy, and most are treated with topical medications, or creams. Oral medications are prescribed when topical treatment fails, but the safety of such agents during pregnancy is controversial. A recent review and analysis examined all relevant studies published on this topic.

The analysis, which is published in the International Journal of Gynecology & Obstetrics, included eight cohort studies and one case-control study. The oral agents used during pregnancy were fluconazole and itraconazole.

Results indicated that oral fluconazole use during pregnancy might slightly increase the risk of congenital heart defects and limb defects relative to the general population, and oral itraconazole use during pregnancy might increase the risk of eye defects. No difference was found between oral fluconazole/itraconazole exposure and non-exposure in the risk of other birth defects, spontaneous abortion, or stillbirth.

"The meta-analysis found that the administration of fluconazole or itraconazole during pregnancy was not associated with an increased risk of overall birth defects, but it was associated with a possible increase in the risk of specific birth defects," the authors wrote.