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Use of benzodiazepines and benzodiazepine receptor agonists during pregnancy: neonatal outcome and congenital malformations

Wikner, Birgitta Norstedt; Stiller, Carl-Olav; Bergman, Ulf; Asker, Charlotte and Källén, Bengt LU (2007) In Pharmacoepidemiology and Drug Safety 16(11). p.1203-1210
Abstract
Background Exposure to Benzodiazepines (BZD) during foetal life has been suggested to contribute to neonatal morbidity and some congenital malformations, for example, orofacial clefts. Here we aimed to study the neonatal outcome and congenital malformations in neonates whose mothers reported use of BZD and/or hypnotic benzodiazepine receptor agonists (HBRA) during pregnancy. Methods In the Swedish Medical Birth Register we identified 1979 infants whose mothers (n = 1944) reported use of BZD and/or HBRA in early pregnancy. An additional 401 infants were studied, born to 390 mothers who were prescribed such drugs during late pregnancy. Neonatal outcome including congenital malformations after exposure was compared with that of all births (n... (More)
Background Exposure to Benzodiazepines (BZD) during foetal life has been suggested to contribute to neonatal morbidity and some congenital malformations, for example, orofacial clefts. Here we aimed to study the neonatal outcome and congenital malformations in neonates whose mothers reported use of BZD and/or hypnotic benzodiazepine receptor agonists (HBRA) during pregnancy. Methods In the Swedish Medical Birth Register we identified 1979 infants whose mothers (n = 1944) reported use of BZD and/or HBRA in early pregnancy. An additional 401 infants were studied, born to 390 mothers who were prescribed such drugs during late pregnancy. Neonatal outcome including congenital malformations after exposure was compared with that of all births (n = 873 879). Results An increased risk for preterm birth and low birth weight was detected in the exposed population. The rate of relatively major congenital malformations was moderately increased among infants exposed in early pregnancy (adjusted OR = 1.24, 95%CI 1.00-1.55), not explained by known teratogenic maternal co-medication. A higher than expected number of infants with pylorostenosis or alimentary tract atresia (especially small gut) was found. This was, however, based on only seven infants for each group of malformation without association to any specific BZD or HBRA. The earlier proposed increased risk for orofacial clefts was not confirmed in our study. Conclusions Maternal use of BZD and/or HBRA may increase the risk for preterm birth and low birth weight and cause neonatal symptoms, but does not appear to have a strong teratogenic potential. The tentative association with pylorostenosis and alimentary tract atresia needs confirmation. Copyright (C) 2007 John Wiley & Sons, Ltd. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
pylorostenosis, congenital malformations, outcome, neonatal, benzodiazepines, hypnotic benzodiazepine receptor agonists, alimentary atresia
in
Pharmacoepidemiology and Drug Safety
volume
16
issue
11
pages
1203 - 1210
publisher
John Wiley & Sons
external identifiers
  • wos:000251021500005
  • scopus:36248985594
ISSN
1053-8569
DOI
10.1002/pds.1457
language
English
LU publication?
yes
id
aa6d6e26-b133-481c-af5b-347458165d1c (old id 968994)
date added to LUP
2008-01-30 15:51:19
date last changed
2017-08-20 03:35:53
@article{aa6d6e26-b133-481c-af5b-347458165d1c,
  abstract     = {Background Exposure to Benzodiazepines (BZD) during foetal life has been suggested to contribute to neonatal morbidity and some congenital malformations, for example, orofacial clefts. Here we aimed to study the neonatal outcome and congenital malformations in neonates whose mothers reported use of BZD and/or hypnotic benzodiazepine receptor agonists (HBRA) during pregnancy. Methods In the Swedish Medical Birth Register we identified 1979 infants whose mothers (n = 1944) reported use of BZD and/or HBRA in early pregnancy. An additional 401 infants were studied, born to 390 mothers who were prescribed such drugs during late pregnancy. Neonatal outcome including congenital malformations after exposure was compared with that of all births (n = 873 879). Results An increased risk for preterm birth and low birth weight was detected in the exposed population. The rate of relatively major congenital malformations was moderately increased among infants exposed in early pregnancy (adjusted OR = 1.24, 95%CI 1.00-1.55), not explained by known teratogenic maternal co-medication. A higher than expected number of infants with pylorostenosis or alimentary tract atresia (especially small gut) was found. This was, however, based on only seven infants for each group of malformation without association to any specific BZD or HBRA. The earlier proposed increased risk for orofacial clefts was not confirmed in our study. Conclusions Maternal use of BZD and/or HBRA may increase the risk for preterm birth and low birth weight and cause neonatal symptoms, but does not appear to have a strong teratogenic potential. The tentative association with pylorostenosis and alimentary tract atresia needs confirmation. Copyright (C) 2007 John Wiley & Sons, Ltd.},
  author       = {Wikner, Birgitta Norstedt and Stiller, Carl-Olav and Bergman, Ulf and Asker, Charlotte and Källén, Bengt},
  issn         = {1053-8569},
  keyword      = {pylorostenosis,congenital malformations,outcome,neonatal,benzodiazepines,hypnotic benzodiazepine receptor agonists,alimentary atresia},
  language     = {eng},
  number       = {11},
  pages        = {1203--1210},
  publisher    = {John Wiley & Sons},
  series       = {Pharmacoepidemiology and Drug Safety},
  title        = {Use of benzodiazepines and benzodiazepine receptor agonists during pregnancy: neonatal outcome and congenital malformations},
  url          = {http://dx.doi.org/10.1002/pds.1457},
  volume       = {16},
  year         = {2007},
}