Benzodiazepines usage during pregnancy and the risk of miscarriage
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Reviewed by Dat Tien Nguyen, B.A, ScM.
Translated by Nhi Phuong Quynh Le, B.A |
Posted on June 19th, 2024
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Benzodiazepines are frequently prescribed to treat anxiety and insomnia in pregnant women. However, the molecule can cross the placental barrier, so there has been concern that the substance can increase the risk of abnormal fetal development and miscarriage. Recent studies that examine this association contain several confounders such as maternal comorbidities, lifestyle, and the severity of anxiety and insomnia. Thus, a population-wide study was conducted to examine the in utero effect of benzodiazepines.
The case-control observational study was conducted in Taiwan using the National Health Insurance database, which aggregated a total of 3 million pregnancy reports. Among these, approximately 135,000 reports of miscarriage occurring between the 8th and 19th weeks of pregnancy were selected for analysis. These miscarriage cases were carefully matched with an equal number of control reports of live births from women of similar age, comorbidities, and lifestyle factors. The comparison between the cases and controls indicated that benzodiazepine usage during pregnancy increases the risk of miscarriage by 69%. When analyzed by dose level, the risk increased from 61% in the low-dose group to 86% in the high-dose group. Also, there was no significant difference in risk between long-acting and short-acting benzodiazepines. Among different types of benzodiazepines, fludiazepam was associated with the highest increase in miscarriage risk at 152%, while other benzodiazepines (alprazolam, diazepam, lorazepam, and oxazolam) increased the risk by around 50%.
The case-control observational study was conducted in Taiwan using the National Health Insurance database, which aggregated a total of 3 million pregnancy reports. Among these, approximately 135,000 reports of miscarriage occurring between the 8th and 19th weeks of pregnancy were selected for analysis. These miscarriage cases were carefully matched with an equal number of control reports of live births from women of similar age, comorbidities, and lifestyle factors. The comparison between the cases and controls indicated that benzodiazepine usage during pregnancy increases the risk of miscarriage by 69%. When analyzed by dose level, the risk increased from 61% in the low-dose group to 86% in the high-dose group. Also, there was no significant difference in risk between long-acting and short-acting benzodiazepines. Among different types of benzodiazepines, fludiazepam was associated with the highest increase in miscarriage risk at 152%, while other benzodiazepines (alprazolam, diazepam, lorazepam, and oxazolam) increased the risk by around 50%.