Yeast Infections During Pregnancy | Complications of Untreated Infection

During pregnancy, a woman is at an increased risk of contracting several different types of infections, including urinary tract infections (UTI) and bacterial vaginosis (BV).

A yeast infection is another condition that is very common for expecting mothers, especially during their second and third trimesters. You already may be well aware of yeast infections. An estimated 75% of all women have a yeast infection in their lifetime.

While a yeast infection can be quite annoying and uncomfortable (particularly during the third trimester of pregnancy), it is generally harmless and can be easily treated with antifungal medication. Still, it’s important to treat this condition as early as possible. Because you want to avoid transferring the infection to the baby during labor and delivery.

Read below to find out more about this condition, the causes, available treatments, and how to prevent one in the future.

A yeast infection is not a sexually transmitted infection (STI), but women often develop the condition after they first become regularly sexually active. It may also be linked to mouth-to-genital contact (oral-genital sex). This infection affects up to 3 out of 4 women, making it extremely common. Fortunately, yeast infections are not considered serious and can be cured within two weeks with appropriate treatment.

Why? Several factors make pregnant women more prone to yeast infections:

• Hormonal Fluctuations: Elevated levels of estrogen increase glycogen production in the vaginal lining, which in turn provides a favorable environment for yeast proliferation. This happens because pregnancy increases the release of the hormone estrogen which can upset the vagina’s chemical balance. Pregnant women also have a higher amount of sugar in their vaginal secretions, making it easier for the yeast to grow.
• Weakened Immune System: Pregnancy naturally suppresses the immune system to ensure the fetus isn’t rejected by the body, which can also reduce the body’s ability to ward off yeast.
• Increased Vaginal Discharge: Pregnancy causes an increase in vaginal discharge, which can create a moist environment conducive to yeast growth.

Other risk factor include:

• Taking hormone medication
• Taking antibiotics
• Taking steroids
• Having high blood sugar or diabetes
• Sex
• Douching
• An impaired immune system

• An increased amount of discharge
• Watery vaginal discharge
• Discharge that looks white/tan in color, or possibly green/yellow
• Discharge that looks similar to cottage cheese (odorless)
• Discharge smells like yeast/bread
• Itching or irritation in the vagina and vulva
• Redness or swelling of the vulva
• Burning sensation during urination or intercourse

Pregnant women are more likely to have what’s called a “complicated yeast infection.” This simply means that you may experience multiple yeast infections throughout your pregnancy, which can create chronic symptoms that take longer to resolve. This is considered normal and is not a cause for concern, especially if you are in your second or third trimester.

Diagnosing a yeast infection typically involves a pelvic exam and may be confirmed through lab tests. Fortunately, yeast infections can be treated, even during pregnancy. It’s crucial to consult with a healthcare provider about the safest and most effective treatment options. Over-the-counter antifungal creams are commonly prescribed, though oral antifungal medications are usually avoided during pregnancy due to potential side effects.

Instead of an oral pill, doctors will recommend you take vaginal creams and suppositories to cure the infection. These are anti-fungal medications that fight off overgrown yeast and restore the vaginal balance. Only certain creams and suppositories are safe to use during pregnancy. Treatments like Terazol or Monistat are generally considered safe for pregnant women, but make sure to consult with your doctor to get their professional opinion.

It may take up to two weeks to fully get rid of a yeast infection, but the uncomfortable symptoms may subside within the first few days. After the infection has cleared, it may be beneficial to use a starch-free drying powder to prevent another infection.

New studies suggest that zinc might be key to better treating vaginal yeast infections, which affect many women around the world. Researchers discovered that the yeast causing these infections, mainly Candida albicans, produces a molecule to help it consume zinc. This molecule also seems to cause inflammation, which leads to the uncomfortable symptoms of thrush. By adding a small amount of zinc to the environment, it might stop the yeast from making this inflammatory molecule and prevent the symptoms.

But an untreated yeast infection has the possibility of passing to your baby’s mouth during labor and delivery. This condition is called “thrush.”, You want to avoid thrush. Still, it can be treated with the Nystatin, another anti-fungal medication. So pregnant women need to visit their doctor as soon as they start experiencing symptoms.

That said, if a persistent yeast infection during pregnancy gains steam and travels through the vagina or blood, there is a risk, albeit low, of complications. It can in rare cases cause chorioamnionitis, prematurity, endometriosis, and neonatal sepsis.

• Wear loose, breathable cotton underwear.
• After showering, use your blow dryer on a low, cool setting to help dry the outside of your genital area.
• Always wipe from front to back when using the restroom.
• Avoid wearing damp, wet clothes. Change your clothes immediately after swimming or working out.
• Include yogurt with the bacteria “lactobacillus acidophilus” in your diet.
• Limit your sugar intake, as sugar promotes the growth of yeast.

Avoid using these:

• Tight-fitting pants or pantyhose
• Douching
• Feminine hygiene sprays
• Sanitary pads and tampons that contain deodorant or scents
• Taking a bubble bath or sitting in a hot tub
• Using scented soaps
• Using colored or perfumed toilet paper

Dealing with a Yeast Infection During Pregnancy

Overall, yeast infections are more of a nuisance than a concern during pregnancy. But there are enough rare occasions with tragic outcomes not to not only keep an eye on your yeast infection but to also consult with your doctor to make sure it is under control.

But the good news is as awful as yeast infections can be, they are usually easy to treat and only rarely present long-term complication even for reoccurring yeast infections.

If your symptoms are particularly hard to manage, talk to your doctor about other over-the-counter medications that specifically treat burning sensations, itchiness, and swelling. Remember to completely finish the entire course of medication to get rid of the infection completely and prevent it from coming back.

Sources and Additional Literature

Gigi, R. M. S., et al. (2023). Vulvovaginal yeast infections during pregnancy and perinatal outcomes: systematic review and meta-analysis. BMC Womens Health, 23(116). https://doi.org/10.1186/s12905-023-02258-7. The study concluded that the risk of having a baby early (preterm birth) was just about the same for women with and without a yeast infection. Even when they checked the results based on whether women had symptoms or not, they did not find a significant difference. Other problems during pregnancy were not really linked to yeast infections either.

Elkady, A., Sinha, P., & Hassan, S. A. Z. (Eds.). (2019). Infections in Pregnancy: An Evidence-Based Approach. Cambridge University Press. Book addresses challenges healthcare providers face in diagnosing, treating, and managing infections in pregnant women.

Vieira-Baptista, P., & Bornstein, J. (2019). Candidiasis, Bacterial Vaginosis, Trichomoniasis, and Other Vaginal Conditions Affecting the Vulva. Vulvar Disease (pp. 167-205). Springer, Cham. This chapter The chapter delves into various infections and conditions that affect the vagina and, by extension, the vulva, including bacterial vaginosis and yeast infections.

Jeanmonod, R., et al. (2019). Vaginal Candidiasis (Vulvovaginal Candidiasis). StatPearls.

Presterl, E., et al. (2019). Medical Mycology: Fungal Infections. Basic Microbiology and Infection Control for Midwives (pp. 155-159). Springer, Cham.

Chatzivasileiou, P., & Vyzantiadis, T. A. (2019). Vaginal yeast colonisation: From a potential harmless condition to clinical implications and management approaches-A literature review. Mycoses: Diagnosis, Therapy, and Prophylaxis of Fungal Diseases.