Benzodiazepine Use in Pregnancy And Risk Of Miscarriage - EMJ

Does Benzodiazepine Use in Pregnancy Increase Miscarriage Risk?

1 Mins
Reproductive Health

BENZODIAZEPINE use during pregnancy has raised significant concerns due to potential harmful effects on the mother and fetus. Findings from a recent study suggest that benzodiazepine use during pregnancy is associated with an increased risk of miscarriage.  

“When used during pregnancy, benzodiazepines can readily cross the placental barrier and accumulate substantially in embryo and fetal tissues,” explained study author Lin-Chieh Meng, College of Medicine, National Taiwan University, Taipei, Taiwan. “Given their potential role in cell proliferation and differentiation processes, it is plausible that benzodiazepines may cause fetal developmental abnormalities, ultimately leading to miscarriage.” 

The authors conducted a nationwide, population-based case-time-control study using Taiwan’s National Birth Certificate Application database and the National Health Insurance database, to quantify the risk of miscarriage associated with benzodiazepine use during pregnancy. The study included a total of 3,067,122 pregnancies among 1,957,601 females (mean age: 30.61 years) between 2004–2017.  

Pregnancies that resulted in miscarriage were included in the case group and matched with control individuals using disease risk score, considering demographic characteristics, and pre-pregnancy comorbidities. Discordant benzodiazepine exposures were assessed during the risk period (1–28 days before miscarriage) and during two reference periods (31–58 days and 181–208 days before last menstruation). 

A total of 136,134 pregnancies (4.4%) resulted in miscarriage. Overall, 1,502 pregnancies were exposed to benzodiazepines during the risk period, and 2,806 were exposed during the reference periods. Significantly, the team found that the use of benzodiazepines during pregnancy was associated with an almost 70% increased risk of miscarriage (odds ratio [OR]: 1.69; 95% confidence interval [CI]: 1.52–1.87). Furthermore, findings revealed that each commonly used individual benzodiazepine was associated with an increased risk of miscarriage, ranging from an OR of 1.39 (95% CI: 1.17–1.66) for alprazolam, to an OR of 2.52 (95% CI: 1.89–3.36) for fludiazepam. 

The findings of this study have significant implications for healthcare professionals and pregnant females. Given the increased risk of miscarriage associated with benzodiazepine use, it is crucial for healthcare providers to carefully weigh the risks and benefits when considering the use of these drugs to treat psychiatric and sleep disorders during pregnancy. 

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