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The authors report no conflict of interest.
Cite this article as: Daniel S, Rotem R, Koren G, et al. Vaginal antimycotics and the risk for spontaneous abortions. Am J Obstet Gynecol 2018;218:601.e1-7.
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- ReplyAmerican Journal of Obstetrics & GynecologyVol. 219Issue 6
- PreviewWe thank Drs Xu and Du for their comment on our study. An adverse effect of a drug may develop in 2 ways: the first is a remote or a cumulative effect, in which an adverse phenomenon occurs relatively far from the exposure; the second is an acute effect, in which the adverse phenomenon occurs in the days after the exposure.
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- Vaginal antifungal during pregnancy and risk of spontaneous abortionsAmerican Journal of Obstetrics & GynecologyVol. 219Issue 6
- PreviewWe read with interest the article “Vaginal antimycotics and the risk for spontaneous abortions” by Daniel et al.1 The researchers used the medical center–based cohort of 65,457 pregnancies and compared those that were exposed to vaginal antifungal medications with up to 20 unexposed pregnancies. They found an insignificantly increased risk of spontaneous abortion associated with antimycotics exposure (crude hazard ratio, 1.11; 95% confidence interval, 0.96–1.29). Daniel et al concluded that “No increased risk for spontaneous abortions was detected following exposure to vaginal anti-mycotic drugs and the study reinforces the safety of use of these drugs (vaginal antimycotics) during the first trimester of pregnancy.” This is in accordance with the currently recommended advice that intravaginal formulations of topical azole antifungals are the first-line treatment for pregnant women.
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