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

Freeman, Marlene P.; Góez-Mogollón, Lina; McInerney, Kathryn A.; Davies, Abigail C.; Church, Taylor R.; Sosinsky, Alexandra Z.; Noe, Olivia; Viguera, Adele C.; Cohen, Lee S.

doi:10.1016/j.genhosppsych.2018.05.010

Cited by 31 publications

(18 citation statements)

References 39 publications

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“…The frequency of antidepressant use in pregnant women varies worldwide, ranging from 1.8% to up 10% [13–17]. During the pregnancy, the prevalence of benzodiazepine use, an anxiolytic, is around 5% [12, 18, 19].…”

Section: Introductionmentioning

confidence: 99%

“…The literature on benzodiazepine use in pregnancy is dominated by studies on the risk of fetal malformations. The association between HDP risk and anxiolytic medication exposure has been explored by few studies [18, 30]. In a recent study, benzodiazepine use during pregnancy increased the HDP risk, but the association was not significant in adjusted models [30].…”

Section: Introductionmentioning

confidence: 99%

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Use of antidepressants and anxiolytics in early pregnancy and the risk of preeclampsia and gestational hypertension: a prospective study

Bernard

Forest

Tarabulsy

et al. 2019

BMC Pregnancy Childbirth

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Background We investigated the association between antidepressant and anxiolytic exposure during the first and early second trimester of pregnancy (< 16 weeks), and hypertensive disorders of pregnancy (including preeclampsia and gestational hypertension) in women with singleton pregnancy. Methods This study is based on a large prospective cohort of 7866 pregnant women. We included pregnant women aged 18 years or older without chronic hepatic or renal disease at the time of recruitment. Participants lost to the follow-up, with multiple pregnancies and pregnancy terminations, miscarriages or fetal deaths before 20 weeks of gestation were excluded from the study, as well as women with no data on the antidepressant/anxiolytic medication use during pregnancy. Information concerning antidepressant or anxiolytic medication use was extracted from hospital records after delivery. The associations between their use and the risk of gestational hypertension or preeclampsia were calculated. Results The final sample for analysis included 6761 participants including 218 (3.2%) women who were exposed to antidepressant and/or anxiolytic medication before the 16th week of gestation. Forty-one women had a non-medicated depression or anxiety during the pregnancy. Moreover, 195 (2.9%) and 122 (1.8%) women developed gestational hypertension and preeclampsia respectively. When compared to women unexposed to antidepressant/anxiolytic medication, depression and anxiety, those using antidepressant and/or anxiolytic drugs before the 16th week of gestation were at increased risk of preeclampsia (adjusted odd ratio (aOR) 3.09 [CI 95% 1.56–6.12]), especially if they continued their medication after the 16th week (aOR 3.41 [CI 95% 1.66–7.02]) compared to those who did not (1.60 [CI 95% 0.21–12.34]). Conclusions Women exposed to antidepressant and/or anxiolytic medication before the 16th week of pregnancy have a 3-fold increased risk for preeclampsia when compared to women unexposed to antidepressant/anxiolytic medication, depression and anxiety. Also, our results suggested that women who stopped their medication before the 16th week of pregnancy could be benefit from reduced preeclampsia risk.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Use of antidepressants and anxiolytics in early pregnancy and the risk of preeclampsia and gestational hypertension: a prospective study

Bernard

Forest

Tarabulsy

et al. 2019

BMC Pregnancy Childbirth

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“…Benzodiazepines are commonly used to treat anxiety disorders, anxiety symptoms of other psychiatric disorders, seizures and insomnia, but are also used to prevent and treat symptoms of preeclampsia [31] . We excluded benzodiazepines that were used for the treatment of preeclampsia symptoms from this analysis (accounting for 25.3% of benzodiazepine use).…”

Section: Discussionmentioning

confidence: 99%

Maternal use of drugs and preeclampsia

Sahlman

Koponen

El‐Nezami

et al. 2019

Brit J Clinical Pharma

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“…Pharmacological interventions for perinatal anxiety and depressive symptoms have negative complications in terms of both maternal and child outcomes [4]: Benzodiazepines and most antidepressants can cross the placental barrier, and are associated with preterm labour and low birth weight in newborns [14][15][16]. Compared with no exposure to pharmacological treatment, women exposed to relaxants and antidepressants before the 16th week of pregnancy have a three-fold increased risk of preeclampsia [14,17].…”

Section: Introductionmentioning

confidence: 99%

Effects of Music Interventions on Maternal and Child Outcomes in Obstetric Settings: An Updated Systematic Review and Meta-Analysis

De¹,

Zeng²,

Tang³

et al. 2020

Int. J. Gynecol. Obst. Res.

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Introduction: Pregnancy and childbirth are highly challenging, as it is an event of significant psychological, social and emotional change for women that may predispose them to stress and anxiety. Music therapy is emerging with increasing popularity as an additional treatment for ameliorating stress, anxiety and labor pain. This study aimed to examine the effect of music interventions on maternal perinatal mental health and childbirth outcomes to establish comprehensive evidence for clinical decision-making. Methods: This study is a systematic review and meta-analysis. Results: Twenty-six randomized controlled trials (RCTs) involving 3,969 women included in this review. The overall effects indicated that anxiety levels in women in the music group were significantly lower than in the usual care group (SMD =-4.17, 95% CI:-5.13 to-3.20). The pooled results also indicate that music interventions could significantly reduce depressive symptoms (SMD =-2.66, 95% CI:-4.98 to-0.34). The music interventions also tended to reduce women's stress, but without significantly statistical differences (Z=1.84, P=0.07). Eight studies reported the effects of music interventions on the physical outcomes of pain and blood pressure and pain. Music interventions could significantly reduce pain intensity (SMD =-1.43, 95% CI:-2.67 to-0.18, blood pressure: systolic BP (SMD =-2.23, 95% CI:-3.76 to-0.70), and diastolic BP (SMD =-1.80, 95% CI:-3.00 to-0.61), and reduced heart rate vital signs (SMD =-3.33, 95% CI:-4.36 to-2.30). Five studies reported the effects of music interventions on women's satisfaction and quality of life, and found that music interventions significantly improved these outcomes (SMD =2.86, 95% CI: 1.66 to 4.05). In terms of child outcomes, the music interventions positively stimulated fetal movement (SMD =1.62, 95% CI: 0.05 to 3.19) and accelerations (SMD =1.08, 95% CI: 0.74 to 1.42). Conclusions: These results suggest that music interventions may have the potential to reduce obstetrical complications, so that application of music interventions across all three trimesters and during labor may be advisable in routine obstetric practice.

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

Abstract: 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.

Cited by 31 publications

References 39 publications

Use of antidepressants and anxiolytics in early pregnancy and the risk of preeclampsia and gestational hypertension: a prospective study

Use of antidepressants and anxiolytics in early pregnancy and the risk of preeclampsia and gestational hypertension: a prospective study

Maternal use of drugs and preeclampsia

Effects of Music Interventions on Maternal and Child Outcomes in Obstetric Settings: An Updated Systematic Review and Meta-Analysis

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