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Gen Hosp Psychiatry. 2018 Jul - Aug;53:73-79. doi: 10.1016/j.genhosppsych.2018.05.010. Epub 2018 May 29.

Obstetrical and neonatal outcomes after benzodiazepine exposure during pregnancy: Results from a prospective registry of women with psychiatric disorders.

Author information

1
Massachusetts General Hospital, Center for Women's Mental Health, 185 Cambridge St, Boston, MA 02114, United States. Electronic address: mfreeman@partners.org.
2
Massachusetts General Hospital, Center for Women's Mental Health, 185 Cambridge St, Boston, MA 02114, United States.
3
Massachusetts General Hospital, Center for Women's Mental Health, 185 Cambridge St, Boston, MA 02114, United States; Boston University School of Public Health, Department of Epidemiology, 715 Albany Street, The Talbot Building, T3E & T4E, Boston, MA 02118, United States.
4
Massachusetts General Hospital, Center for Women's Mental Health, 185 Cambridge St, Boston, MA 02114, United States; Cleveland Clinic, Cleveland Clinic Neurological Institute, 6770 Mayfield Rd #226, Cleveland, OH 44123, United States.

Abstract

OBJECTIVE:

The goal of this analysis was to examine the effect of benzodiazepine use during pregnancy on maternal and neonatal outcomes in a cohort of women with psychiatric disorders.

METHODS:

794 evaluable women from the Massachusetts General Hospital National Pregnancy Registry for Psychiatric Medications were followed across pregnancy (N = 144 exposed to benzodiazepines and N = 650 unexposed). Data obtained through maternal report and medical records included maternal outcomes (cesarean section, preeclampsia) and neonatal outcomes (birth weight, breathing difficulty, feeding difficulty, head circumference, 5-minute Apgar score, muscular and/or extrapyramidal symptoms, NICU admission, prematurity).

RESULTS:

In adjusted analyses, infants exposed to benzodiazepines in utero were more likely to be admitted to the NICU (OR: 2.02, 95% CI: 1.11, 3.66) and to have small head circumferences (OR: 3.89, 95% CI: 1.25, 12.03) compared to unexposed infants. Other neonatal adverse effects such as respiratory distress or muscular symptoms including hypotonia were not observed. There were no significant differences in adverse obstetrical outcomes.

CONCLUSIONS:

Infants exposed to benzodiazepines during pregnancy had an increased risk of NICU admissions and small head circumferences. Confounding from psychiatric symptoms and other variables cannot be ruled out as contributors to these findings.

KEYWORDS:

Anxiety; Benzodiazepines; Obstetrics; Pharmacotherapy; Women's health

[Indexed for MEDLINE]

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