Benzodiazepine exposure in pregnancy does not up risk for ADHD, autism

Benzodiazepine exposure during pregnancy seems not to be associated with increased risks for development of attention-deficit/hyperactivity disorder (ADHD) or autism spectrum disorder (ASD), according to a study published online Nov. 22 in JAMA Network Open.

Vincent Chin-Hung Chen, M.D., from Chiayi Chang Gung Memorial Hospital in Chiayi, Taiwan, and colleagues conducted a cohort study to examine whether prenatal benzodiazepine exposure is associated with development of ASD and ADHD. Data were included for 1,138,732 mothers with 1,516,846 live births between Jan. 1, 2004, and Dec. 31, 2017.

Overall, 5.0 percent of the children were exposed to a benzodiazepine during pregnancy. The researchers found that benzodiazepine exposure was associated with increased risks for ADHD (hazard ratios [95 percent confidence intervals], 1.24 [1.20 to 1.28], 1.27 [1.21 to 1.34], and 1.25 [1.14 to 1.37] for first-, second-, and third-trimester exposure, respectively) and ASD (hazard ratios [95 percent confidence intervals], 1.13 [1.05 to 1.21], 1.10 [0.98 to 1.22], and 1.21 [1.00 to 1.47] for first-, second-, and third-trimester exposure, respectively). However, compared with unexposed sibling controls during the same period, the differences were no longer significant for ADHD (hazard ratios [95 percent confidence intervals], 0.91 [0.83 to 1.00], 0.89 [0.78 to 1.01], and 1.08 [0.83 to 1.41] for first-, second-, and third-trimester exposure, respectively) or ASD (hazard ratios [95 percent confidence intervals], 0.92 [0.75 to 1.14], 0.97 [0.71 to 1.33], and 1.07 [0.53 to 2.16] for first-, second-, and third-trimester exposure, respectively).

"Our results challenge current assumptions of a potential association of neurodevelopmental disorders with maternal benzodiazepine use before or during pregnancy," the authors write.

Several authors disclosed financial ties to the pharmaceutical industry.

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