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Reprod Toxicol. 2015 Apr;52:78-82. doi: 10.1016/j.reprotox.2015.02.009. Epub 2015 Feb 25.

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

Author information

1
The Motherisk Program, Division of Clinical Pharmacology and Toxicology, Department of Pediatrics, Hospital for Sick Children and University of Toronto, 555 University Ave, Toronto, ON M5G 1X8, Canada; Leslie Dan Faculty of Pharmacy, University of Toronto, 144 College street, Toronto, ON M5S 3M2, Canada; Department of Pharmacology & Toxicology, College of Pharmacy, King Saud University, Riyadh, KSA.
2
The Motherisk Program, Division of Clinical Pharmacology and Toxicology, Department of Pediatrics, Hospital for Sick Children and University of Toronto, 555 University Ave, Toronto, ON M5G 1X8, Canada; Terafar-Izmir Katip Celebi University Teratology Information, Training and Research Center, Izmir, Turkey.
3
The Motherisk Program, Division of Clinical Pharmacology and Toxicology, Department of Pediatrics, Hospital for Sick Children and University of Toronto, 555 University Ave, Toronto, ON M5G 1X8, Canada; Leslie Dan Faculty of Pharmacy, University of Toronto, 144 College street, Toronto, ON M5S 3M2, Canada. Electronic address: gkoren@sickkids.ca.

Abstract

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.

KEYWORDS:

Cardiovascular defects; Fluconazole; Infants; Pregnancy; Teratogenicity; Vulvovaginal candidiasis

PMID:
25724389
DOI:
10.1016/j.reprotox.2015.02.009
[Indexed for MEDLINE]

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