Maternal Benzodiazepines and Z-Drugs Use during Pregnancy and Adverse Birth and Neurodevelopmental Outcomes in Offspring: A Population-Based Cohort Study.

IF 16.3 1区医学 Q1 PSYCHIATRY

Psychotherapy and Psychosomatics Pub Date : 2023-01-01 DOI:10.1159/000529141

Adrienne Y L Chan, Le Gao, Louise M Howard, Emily Simonoff, Dave Coghill, Patrick Ip, Wallis C Y Lau, Katja Taxis, Ian C K Wong, Kenneth K C Man

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引用次数: 2

Abstract

Introduction: The use of benzodiazepines and/or z-drugs in women of childbearing age has increased.

Objective: The aim of the study was to evaluate whether gestational benzodiazepine and/or z-drug exposure is associated with adverse birth and neurodevelopmental outcomes.

Methods: A population-based cohort including mother-child pairs from 2001 to 2018 in Hong Kong was analysed to compare gestationally exposed and nonexposed children on the risk of preterm birth, small for gestational age, autism spectrum disorder (ASD), and attention-deficit/hyperactivity disorder (ADHD) through logistic/Cox proportional hazards regression with a 95% confidence interval (CI). Sibling-matched analyses and negative control analyses were applied.

Results: When comparing gestationally exposed with gestationally nonexposed children, the weighted odds ratio (wOR) was 1.10 (95% CI = 0.97-1.25) for preterm birth and 1.03 (95% CI = 0.76-1.39) for small for gestational age, while the weighted hazard ratio (wHR) was 1.40 (95% CI = 1.13-1.73) for ASD and 1.15 (95% CI = 0.94-1.40) for ADHD. Sibling-matched analyses showed no association between gestationally exposed children and their gestationally nonexposed siblings for all outcomes (preterm birth: wOR = 0.84, 95% CI = 0.66-1.06; small for gestational age: wOR = 1.02, 95% CI = 0.50-2.09; ASD: wHR = 1.10, 95% CI = 0.70-1.72; ADHD: wHR = 1.04, 95% CI = 0.57-1.90). Similarly, no significant differences were observed when comparing children whose mothers took benzodiazepines and/or z-drugs during pregnancy to children whose mothers took benzodiazepines and/or z-drugs before but not during pregnancy for all outcomes.

Conclusions: The findings do not support a causal relationship between gestational benzodiazepines and/or z-drugs exposure and preterm birth, small for gestational age, ASD, or ADHD. Clinicians and pregnant women should carefully balance the known risks of benzodiazepines and/or z-drugs use against those of untreated anxiety and sleep problems.

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妊娠期间母体苯二氮卓类药物和z类药物的使用、不良出生和后代神经发育结局:一项基于人群的队列研究。

导读:育龄妇女苯二氮卓类药物和/或z类药物的使用有所增加。目的:本研究的目的是评估妊娠期苯二氮卓类药物和/或z-药物暴露是否与不良出生和神经发育结局相关。方法:通过logistic/Cox比例风险回归，以95%置信区间(CI)对香港2001年至2018年的一项基于人群的母婴队列进行分析，比较妊娠暴露和未暴露儿童早产、小胎龄、自闭症谱系障碍(ASD)和注意力缺陷/多动障碍(ADHD)的风险。采用兄弟姐妹配对分析和阴性对照分析。结果:当比较妊娠期暴露与妊娠期未暴露儿童时，早产儿的加权优势比(wOR)为1.10 (95% CI = 0.97-1.25)，小胎龄儿童的加权优势比(wOR)为1.03 (95% CI = 0.76-1.39)，而ASD的加权风险比(wHR)为1.40 (95% CI = 1.13-1.73)， ADHD的加权风险比(wHR)为1.15 (95% CI = 0.94-1.40)。兄弟姐妹配对分析显示，妊娠期暴露的儿童与其妊娠期未暴露的兄弟姐妹在所有结局中均无关联(早产:wOR = 0.84, 95% CI = 0.66-1.06;胎龄小:wOR = 1.02, 95% CI = 0.50-2.09;ASD: wHR = 1.10, 95% CI = 0.70-1.72;ADHD: wHR = 1.04, 95% CI = 0.57-1.90)。同样，将母亲在怀孕期间服用苯二氮卓类药物和/或z-药物的儿童与母亲在怀孕前服用苯二氮卓类药物和/或z-药物的儿童进行比较，在所有结果中没有观察到显著差异。结论:研究结果不支持妊娠期苯二氮卓类药物和/或z类药物暴露与早产、小于胎龄、ASD或ADHD之间的因果关系。临床医生和孕妇应仔细权衡苯二氮卓类药物和/或z类药物的已知风险与未经治疗的焦虑和睡眠问题的风险。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Psychotherapy and Psychosomatics 医学-精神病学

CiteScore

29.40

自引率

6.10%

发文量

期刊介绍： Psychotherapy and Psychosomatics is a reputable journal that has been published since 1953. Over the years, it has gained recognition for its independence, originality, and methodological rigor. The journal has been at the forefront of research in psychosomatic medicine, psychotherapy research, and psychopharmacology, and has contributed to the development of new lines of research in these areas. It is now ranked among the world's most cited journals in the field. As the official journal of the International College of Psychosomatic Medicine and the World Federation for Psychotherapy, Psychotherapy and Psychosomatics serves as a platform for discussing current and controversial issues and showcasing innovations in assessment and treatment. It offers a unique forum for cutting-edge thinking at the intersection of medical and behavioral sciences, catering to both practicing clinicians and researchers. The journal is indexed in various databases and platforms such as PubMed, MEDLINE, Web of Science, Science Citation Index, Social Sciences Citation Index, Science Citation Index Expanded, BIOSIS Previews, Google Scholar, Academic Search, and Health Research Premium Collection, among others.