ArticlePloS one2014
First trimester exposure to anxiolytic and hypnotic drugs and the risks of major congenital anomalies: a United Kingdom population-based cohort study.
Article in PloS one, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 2 of them syntheses that pooled it.
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Who cites it
25 citing papers in PubMed, 2 syntheses or guidelines pooled it, 91 citations in OpenAlex.
- Association between gestational hypnotic benzodiazepine receptor agonists exposure and adverse pregnancy outcomes: a systematic review and meta-analysis.Archives of women's mental health · 2025Pooled it
- The safety of benzodiazepines and related drugs during pregnancy: an updated meta-analysis of cohort studies.Archives of gynecology and obstetrics · 2024Pooled it
- Trial
- Perioperative management of surgical procedure during pregnancy: a systematic review.Annals of medicine and surgery (2012) · 2024Article
- Maternal exposure to zolpidem and risk of specific birth defects.Journal of sleep research · 2024Article
- Management of status epilepticus in pregnancy: a clinician survey.Neurological research and practice · 2024Article
- Consensus Panel Recommendations for the Pharmacological Management of Pregnant Women with Depressive Disorders.International journal of environmental research and public health · 2023Article
- First-trimester exposure to benzodiazepines and risk of congenital malformations in offspring: A population-based cohort study in South Korea.PLoS medicine · 2022Observational
- Anesthetic Management of the Pregnant Patient: Part 2.Anesthesia progress · 2021Review
- Maternal, Fetal, and Child Outcomes of Mental Health Treatments in Women: A Meta-Analysis of Pharmacotherapy.Psychiatric research and clinical practice · 2021Review
- Selecting a pharmacotherapy regimen for patients with chronic insomnia.Expert opinion on pharmacotherapy · 2020Review
- Alcohol, smoking, and other substance use in the perinatal period.BMJ (Clinical research ed.) · 2020Article
- Psychotropic Treatment During Pregnancy: Research Synthesis and Clinical Care Principles.Journal of women's health (2002) · 2020Review
- Review
- Does maternal somatic anxiety in pregnancy predispose children to hyperactivity?European child & adolescent psychiatry · 2019Article
- Use of Prescribed Psychotropics during Pregnancy: A Systematic Review of Pregnancy, Neonatal, and Childhood Outcomes.Brain sciences · 2019Review
- Psychopharmacological Decision Making in Bipolar Disorder During Pregnancy and Lactation: A Case-by-Case Approach to Using Current Evidence.Focus (American Psychiatric Publishing) · 2019Review
- Use of benzodiazepine medications during pregnancy and potential risk for birth defects, National Birth Defects Prevention Study, 1997-2011.Birth defects research · 2019Article
- Medication management of bipolar disorder during the reproductive years.The mental health clinician · 2017Article
- Antiepileptic drugs prescribed in pregnancy and prevalence of major congenital malformations: comparative prevalence studies.Clinical epidemiology · 2017Article
Corrections and comments
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Authors and funding
9 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundDespite their widespread use the effects of taking benzodiazepines and non-benzodiazepine hypnotics during pregnancy on the risk of major congenital anomaly (MCA) are uncertain. The objectives were to estimate absolute and relative risks of MCAs in children exposed to specific anxiolytic and hypnotic drugs taken in the first trimester of pregnancy, compared with children of mothers with depression and/or anxiety but not treated with medication and children of mothers without diagnosed mental illness during pregnancy.
methodsWe identified singleton children born to women aged 15-45 years between 1990 and 2010 from a large United Kingdom primary care database. We calculated absolute risks of MCAs for children with first trimester exposures of different anxiolytic and hypnotic drugs and used logistic regression with a generalised estimating equation to compare risks adjusted for year of childbirth, maternal age, smoking, body mass index, and socioeconomic status.
resultsOverall MCA prevalence was 2.7% in 1,159 children of mothers prescribed diazepam, 2.9% in 379 children with temazepam, 2.5% in 406 children with zopiclone, and 2.7% in 19,193 children whose mothers had diagnosed depression and/or anxiety but no first trimester drug exposures. When compared with 2.7% in 351,785 children with no diagnosed depression/anxiety nor medication use, the adjusted odds ratios were 1.02 (99% confidence interval 0.63-1.64) for diazepam, 1.07 (0.49-2.37) for temazepam, 0.96 (0.42-2.20) for zopiclone and 1.27 (0.43-3.75) for other anxiolytic/hypnotic drugs and 1.01 (0.90-1.14) for un-medicated depression/anxiety. Risks of system-specific MCAs were generally similar in children exposed and not exposed to such medications.
conclusionsWe found no evidence for an increase in MCAs in children exposed to benzodiazepines and non-benzodiazepine hypnotics in the first trimester of pregnancy. These findings suggest that prescription of these drugs during early pregnancy may be safe in terms of MCA risk, but findings from other studies are required before safety can be confirmed.
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