Oral Fluconazole Is Best Avoided During the First Trimester

Studies in animals show that fluconazole is teratogenic; moreover, several reports in humans have suggested excess risk for craniofacial (e.g., cleft palate) and conotruncal (e.g., tetralogy of Fallot) malformations in infants born to women who received fluconazole during the first trimester. To assess the risk associated with fluconazole in doses for treating vulvovaginal candidiasis, investigators examined data from a cohort of some 2 million women covered by Medicaid between 2000 and 2014. The comparison group included women who received topical azoles and those not exposed to fluconazole. Potential confounders included maternal age, vaginal candidiasis, related and other conditions, and concurrent medical treatments.

Among 37,650 (1.9%) …