Is Oral Fluconazole Use During Pregnancy Safe?

We have discouraged use of oral fluconazole during pregnancy since a Danish study showed excess risk for spontaneous abortion and stillbirth among pregnant women who received this drug (Physician's First Watch Jan 6 2016 and JAMA 2016; 315:58). Now, investigators address this issue among almost 1.5 million pregnant women in Sweden and Norway between 2006 and 2014. The 0.67% of the cohort who used fluconazole were matched by propensity scores to those women who did not use this agent.

Overall, neither risk for stillbirth (hazard ratio, 0.76 [95% confidence interval, 0.52–1.10]) nor risk for neonatal death (risk ratio, 0.73 [95% CI, 0.42–1.29]) were higher with exposure to fluconazole. Similar results were obtained regardless of fluconazole do…