Exposure to any benzodiazepine in early pregnancy is associated with an increased risk for spontaneous abortion (SA), reveals a recent research published in JAMA Psychiatry.
Incident use of any benzodiazepine was associated with an 85% risk for spontaneous abortion. Researchers found that 1.4% of cases of SA took place in women who had been exposed to benzodiazepines in early pregnancy, compared to approximately 0.6% among the matched control persons.
The researchers conducted a nested case-control study based on prospective data collection of population-based Qubec pregnancy cohort involving 442,066 pregnancies of women aged 15 – 45 years, between January 1, 1998, to December 31, 2015.
The most frequently prescribed benzodiazepines were lorazepam and clonazepam (44.8% and 23.4%, respectively). The findings showed that short-acting benzodiazepines conferred a greater risk than long-acting agents (81% and 73%, respectively).
“Anxiety and mood disorders need to be treated during pregnancy,” said co-author Anick Bérard, Ph D, professor, Faculty of Pharmacy, Université de Montréal to a news media.
“Given the high prevalence of anxiety and mood disorders during pregnancy, physicians need to evaluate the benefits and risks of using benzodiazepines, given that alternative nonpharmacologic treatments exist,” she said.
Benzodiazepines are anxiolytics (antianxiety agents) used to treat insomnia, anxiety, and mood disorders and were reported to cross the placental barrier and found to alter foetal development in animal studies.
“They are also labeled ‘pregnancy category D,’ indicating that there is human evidence on the increased risk of birth defects — cleft lip and palate [and] urogenital defects,” said Berard.
Bérard stated that previous studies have found that benzodiazepines “are associated with an increased risk of miscarriage, but no one has looked at the effect of specific benzodiazepines, and the duration of action — short or long acting.”
“Future research should replicate findings and compare the use of benzodiazepines and other nonpharmacologic treatment for anxiety and mood disorders in pregnant women,” she added.