Vaginal miconazole and clotrimazole show no additional risk of spontaneous abortion
July 24 2018
The prevalence of vulvovaginal candidiasis (VVC) among pregnant women may be around 20-25%, with around 7% being prescribed antifungals during the first trimester. However, previous small-scale studies have suggested a link between azole antifungals and spontaneous abortion (but generally not stillbirth).
Dr Sharon Daniel and colleagues in Israel recently conducted a retrospective cohort study of 65,457 clinically apparent pregnancies at the Maternity Unit of a regional hospital. No association was seen between spontaneous abortion and either vaginal clotrimazole or vaginal miconazole, even for repeated treatment cycles.
Likelihood of spontaneous abortion among pregnant women treated with azole antifungals, versus those not exposed to antifungals.
N numbers indicate the number of exposed pregnancies. Ratio (black diamond) and 95% confidence intervals (grey dashes). A confidence interval ratio spanning 1 (horizontal grey line) indicates that the treated group is not significantly different from untreated controls. Data taken from Daniel et al (2018), Rosa et al (1987) and Mølgaard-Nielsen et al (2016).