- benzodiazepines cross the placenta - there is a risk of adverse effects in the fetus
- during late pregnancy, or during labour, high doses may result in neonatal hypotonia and/or hypothermia. A mild neonatal respiratory distress may occur.
- physical dependence may occur in infants born to mothers who take benzodiazepines chronically
- use of both benzodiazepine anxiolytics and anxiety in pregnancy is associated with preterm delivery and low birth weight (2)
- short-term neonatal effects of hypotonia, depression, and withdrawal are described
- benzodiazepines are associated with physical dependence and withdrawal symptoms which can be serious
A case-time-control study, benzodiazepine use during pregnancy was associated with an increased risk of miscarriage, even after accounting for unmeasured confounders, including those related to genetics and the family environment (3):
- use of benzodiazepines during pregnancy was associated with an increased risk of miscarriage (OR 1.69, 95%CI 1.52-1.87)
- for individual agents, ORs ranged from 1.39 (alprazolam) to 2.52 (fludiazepam
- the study authors stated that:
- observation of an increased risk of miscarriage associated with benzodiazepine use during pregnancy suggests that benzodiazepines should only be used after a thorough evaluation of the potential benefits and risks for both the mother and child
Reference
- CSM (1997), 23, 10.
- Shyken JM, Babbar S, Babbar S, Forinash A. Benzodiazepines in Pregnancy. Clin Obstet Gynecol. 2019 Mar;62(1):156-167
- Meng L, Lin C, Chuang H, Chen L, Hsiao F. Benzodiazepine Use During Pregnancy and Risk of Miscarriage. JAMA Psychiatry. Published online December 27, 2023. doi:10.1001/jamapsychiatry.2023.4912