A vaginal yeast infection, also known as vulvovaginal candidiasis, is a common fungal infection caused by an overgrowth of the Candida species, most often Candida albicans. This condition is characterized by uncomfortable symptoms like itching, burning, and a thick, white discharge. Yeast infections occur with greater frequency during pregnancy due to hormonal changes. The discomfort an infection causes often prompts concerns about its potential impact on the developing pregnancy.
Candidiasis and Miscarriage Risk
Uncomplicated vaginal yeast infections are generally not associated with an increased risk of miscarriage or congenital anomalies. The infection itself is highly unlikely to cause a pregnancy loss. The risk of miscarriage in any pregnancy is between 10 to 15%, and a typical yeast infection does not elevate this background risk.
It is important to distinguish common vaginal candidiasis from rare, invasive fungal infections that occur in people with severely compromised immune systems. These systemic infections, where Candida spreads beyond the vagina, are much more serious and can lead to fetal loss. The typical yeast infection remains localized, posing no direct threat to the fetus. However, studies suggest a possible link between taking the oral antifungal fluconazole, especially during the first trimester, and an increased chance of miscarriage. This risk is associated with the medication, not the infection itself, which is why topical treatments are strongly favored for pregnant patients.
Hormonal Reasons for Increased Incidence
The hormonal landscape of pregnancy makes vaginal yeast infections much more likely. Elevated estrogen levels play a significant role in this increased susceptibility by promoting the accumulation of glycogen in vaginal lining cells. This glycogen is metabolized into sugar, providing a rich nutrient source that encourages Candida overgrowth. Hormonal shifts also change the vaginal acidity, making the pH more favorable for yeast proliferation. Additionally, pregnancy involves a natural suppression of the immune system, which can reduce the body’s ability to keep the fungal population in check.
Safe Management of Yeast Infections in Pregnancy
Anyone experiencing symptoms of a yeast infection during pregnancy should consult a healthcare provider for a confirmed diagnosis. Symptoms like itching and discharge can mimic those of other infections, such as bacterial vaginosis, which require different treatment. Diagnosis is typically confirmed via a pelvic exam and microscopic examination of a vaginal discharge sample.
The safest and most recommended treatment involves topical antifungal medications, typically creams or suppositories containing azole drugs like miconazole or clotrimazole. These medications are applied directly to the vagina and are considered safe because very little is absorbed into the bloodstream. A seven-day course of topical treatment is often recommended for maximum effectiveness.
Oral fluconazole is generally avoided, particularly in the first trimester, due to the potential association with adverse outcomes and birth defects. While a single low dose may be considered in severe or recurrent cases, this decision is made with caution by a healthcare professional. Topical treatments ensure the infection is managed effectively while minimizing systemic exposure to the developing fetus.
Effects on Delivery and Newborn Health
The presence of a vaginal yeast infection later in pregnancy can have implications for delivery and the newborn. The primary concern is the potential for the baby to acquire the infection while passing through the birth canal. If the mother has an active infection at the time of delivery, the baby may develop oral thrush, a yeast infection of the mouth.
Neonatal thrush is generally mild and treatable, but it can cause feeding difficulties. Untreated or severe candidiasis may also be associated with an increased risk of adverse obstetric outcomes, such as preterm labor, premature rupture of membranes, or low birth weight. Prompt treatment of the maternal infection is important to reduce the chance of transmission and manage these potential complications.