Researchers find risk of miscarriage increases with benzodiazepine use in pregnancy

After accounting for measurable confounders, the risk for miscarriage is increased in association with benzodiazepine use during pregnancy, according to a study published online Dec. 27 in JAMA Psychiatry.

Lin-Chieh Meng, from the National Taiwan University in Taipei, and colleagues quantified the risk for miscarriage associated with benzodiazepine use during pregnancy in a nationwide, population-based case-time-control study.

Pregnancies resulting in miscarriage between 2004 and 2018 were included in the case group and matched in a 1:1 ratio with exposure time-trend control individuals using disease risk score. The study included 3,067,122 pregnancies among 1,957,601 women; 4.4% of these pregnancies resulted in miscarriage.

The researchers found that the risk for miscarriage was increased in association with use of benzodiazepines during pregnancy (odds ratio, 1.69); across multiple sensitivity analyses considering different time windows and accounting for misclassification, the results were consistent. An increased risk for miscarriage was seen in association with commonly used benzodiazepines, ranging from case-time-control odds ratios of 1.39 to 2.52 for alprazolam and fludiazepam, respectively.

"These findings suggest that caution is warranted when using benzodiazepines during early pregnancy," the authors write. "The findings of this study also provide evidence to guide clinicians in making informed decisions regarding the treatment of psychiatric and sleep disorders in pregnant women."

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