Mom's Oral Fluconazole Linked to Bone and Muscle Defects in
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Oral fluconazole in pregnancy was linked to increased risk for congenital bone and muscle abnormalities in a population-based cohort study.

Mothers who took low-dose fluconazole, an antifungal agent used to treat vaginal yeast infections, among other things, during the first trimester were 30% more likely to deliver infants with musculoskeletal malformations (relative risk 1.30, 95% CI 1.09-1.56), Exposure to more than 450 mg of oral fluconazole, or around three doses, nearly doubled the risk of bone and muscle defects at birth, Zhu and colleagues reported in THE BMJ.

The participants in the oral fluconazole cohort were classified in three groups based on dosage: 150 mg, between 150 mg and 450 mg, and more than 450 mg. Women receiving prescriptions for oral fluconazole were compared to two reference groups: those getting no first-trimester prescriptions for oral antifungal agents, and those prescribed topical azoles including butoconazole, clotrimazole, miconazole, terconazole, tioconazole, or nystatin.

The risk of bone and muscle malformations among babies exposed to oral fluconazole in the first trimester was 52.1 (95% CI 44.8-59.3) per 10,000 pregnancies, compared to a risk of 38 (95% CI 37.1-38.9) per 10,000 in those unexposed. Risk for pregnancies exposed to topical azoles was 37.3 (95% CI 33.1-41.4) per 10,000.

Source: https://www.medpagetoday.com/obgyn/pregnancy/86623
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