Plate Nº 65 · recorded October 10, 2026
Health & Medicine ResearchReported finding
Azole antifungal use in pregnancy linked to altered infant hormones
A Danish study of 589 mother–child pairs links prenatal azole antifungal use to altered adrenal hormone levels in infants three months after birth, with lab data backing the finding.
By Marcus Bennett3 min read611 words
In brief
- Researchers analyzed data from 589 Danish mother–child pairs.
- Hormone changes were detected three months after birth in children whose mothers used azole antifungals during pregnancy.
- Most reported antifungal use involved over-the-counter topical preparations such as creams and vaginal tablets.
- Human cohort findings were supported by lab experiments on human fetal adrenal tissue and in pregnant rats.
- The study was published in Communications Medicine in 2026 (DOI: 10.1038/s43856-026-01815-z).
A study of 589 Danish mother–child pairs has found that babies whose mothers used azole-based antifungal medicines during pregnancy showed altered adrenal hormone levels three months after birth.
The research, published in Communications Medicine, drew on data from human fetal adrenal tissue experiments and studies in pregnant rats. A team from the DTU National Food Institute and Copenhagen University Hospital (Rigshospitalet) carried out the work.
What did the researchers measure?
Azole antifungals are a class of medicines that block the synthesis of ergosterol, a key component of fungal cell membranes. They are commonly prescribed — and sold over the counter — for skin, vaginal, and other localized fungal infections.
In the Danish cohort, mothers reported using these medicines during pregnancy. Three months after delivery, researchers measured adrenal hormone levels in the children. Those whose mothers had used azoles showed measurable differences compared with unexposed peers.
"It is striking that the use of azole-based antifungals during pregnancy appears to affect adrenal hormone levels in children long after birth. Although the hormone levels remained within the normal range, the results suggest that fetal development may have been affected," says Terje Svingen, a professor at the DTU National Food Institute.
Which treatments were involved?
Most reported antifungal use during pregnancy came from topical preparations — skin creams and vaginal tablets — that women bought without a prescription. These products have long been considered safe in pregnancy.
Gylli Mola, a researcher and medical doctor at Rigshospitalet, highlights why this matters: "This is particularly noteworthy because the treatments were primarily over-the-counter topical preparations, such as creams and vaginal tablets, which have traditionally been considered safe to use during pregnancy."
Why do adrenal hormones matter?
The adrenal glands sit atop the kidneys and produce hormones that help regulate:
- Glucose metabolism
- Blood pressure
- Immune function
- Growth
- Reproductive development
A short-term hormone shift within the normal range may not cause symptoms. The open question is whether the pattern observed at three months carries longer-term consequences for growth, metabolism, or fertility.
What did the lab experiments show?
To probe a possible mechanism, the team exposed human fetal adrenal tissue to azoles in the laboratory. They also gave azoles to pregnant rats and examined blood and adrenal tissue from the fetuses.
Both lines of experiment pointed in the same direction as the human cohort data: azole exposure disrupted fetal steroidogenesis — the process by which the body builds steroid hormones.
Monica Kam Draskau, a researcher at DTU who worked on the experimental analyses, says: "The fact that the findings in children are supported by results from both human fetal adrenal tissue and experiments in rats strengthens our hypothesis that there is a link with the use of azole-based antifungal medicines."
What can the results not tell us?
The study has clear limits, which the authors emphasize:
- The human data show association, not causation
- The team cannot conclude that azole antifungals harm children
- The cohort is modest at 589 pairs
- A single hormone measurement at three months does not capture later effects
The researchers therefore believe the safety of widely used antifungals during pregnancy warrants further investigation. Fungal infections themselves can also pose risks in pregnancy, which means any future change in clinical guidance must weigh benefits against unknowns.
How large is the signal?
Hormone levels in exposed children stayed within the reference range used in clinical practice. Statistical analyses, not raw measurements, separated exposed from unexposed groups. The difference is not large enough to flag individual babies as abnormal. It is, however, large enough — and consistent across human and lab data — to justify more research into a class of medicines that millions of pregnant women use each year.
via Medical Xpress (Source)
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