WEDNESDAY, May 15, 2019 (Pharmacist's Briefing) -- The risk for spontaneous abortion (SA) is increased among early pregnancies with incident exposure to benzodiazepines, according to a study published online May 15 in JAMA Psychiatry.
Odile Sheehy, from the Centre Hospitalier Universitaire Sainte-Justine in Montreal, and colleagues quantified the risk for SA associated with gestational benzodiazepine incident use in a nested case-control study. Data were included for 442,066 pregnancies, of which 27,149 ended with SA, which was defined as a pregnancy loss between the start of the sixth week of gestation and the 19th completed week of gestation.
The researchers found that 1.4 percent of women exposed to benzodiazepines in early pregnancy and 0.6 percent of matched controls had pregnancies ending with SA (crude odds ratio, 2.39). Compared with nonuse, benzodiazepine exposure in early pregnancy was associated with increased SA risk after adjustment for potential confounders, including maternal mood and anxiety disorders before pregnancy (adjusted odds ratio, 1.85). The risk was similar with exposure to short-acting or long-acting benzodiazepines during early pregnancy (adjusted odds ratios, 1.81 and 1.73, respectively). Independent associations were observed for all benzodiazepine agents and an increased risk for SA (range of adjusted odds ratios, 1.13 to 3.43).
"The findings suggest that health care clinicians should carefully evaluate the risk-benefit ratio of benzodiazepines for the treatment of insomnia and mood or anxiety disorders in early pregnancy," the authors write.
One author disclosed being a consultant for plaintiffs in litigation involving antidepressants and birth defects.