ArticleBMC pregnancy and childbirth2025
Use of benzodiazepine receptor agonists in different pregnancy trimesters and risk of maternal and neonatal outcomes: a propensity weighted cohort study in Taiwan.
Article in BMC pregnancy and childbirth, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundThe association between benzodiazepine receptor agonist (BZRA) exposure and adverse perinatal outcomes remains inconclusive. This study aimed to assess the risks of adverse pregnancy and neonatal outcomes associated with maternal BZRA exposure across pregnancy trimesters.
methodsData from 170,144 maternal BZRA users and 1,098,172 nonusers were obtained from the Taiwan's National Health Insurance database. We used cross-sectional study design with inverse probability of treatment weighting (IPTW) to evaluate the association between maternal BZRA exposure during each trimester and adverse pregnancy outcomes. The pregnancy period was classified into 4 intervals: preconception, first trimester, second trimester, and third trimester. Logistic regression was performed to estimate odds ratios (ORs) and 95% confidence intervals (CIs).
resultsMaternal BZRA exposure was associated with an increased risk of stillbirth (IPTW-OR 1.19, 95% CI 1.14-1.25), preterm birth (IPTW-OR:1.11, 95% CI 1.09-1.13), low birth weight (IPTW-OR:1.05, 95% CI 1.03-1.07), Apgar score < 7 (IPTW-OR:1.17, 95% CI 1.12-1.22), and cesarean delivery (IPTW-OR:1.15, 95% CI 1.14-1.17) compared with nonusers. By timing, preconception exposure was modestly associated with preterm birth and cesarean delivery, and first-trimester exposure showed similar associations. The associations were most pronounced in the second trimester, with significantly elevated risks of stillbirth (2.29, 95% CI 2.11-2.48), preterm birth (1.38, 95% CI 1.33-1.43), Apgar score < 7 (2.05, 95% CI 1.92-2.20), low birth weight (1.35, 95% CI 1.29-1.40), small for gestational age (1.07, 95% CI 1.03-1.11), cesarean Sect. (1.21, 95% CI 1.18-1.24), and overall congenital malformations (1.27, 95% CI 1.13-1.43).
conclusionsThis study observed a small but statistical association between BZRA exposure and several adverse pregnancy outcomes, which extended from the pre-pregnancy period through all trimesters. Clinicians should carefully weigh the risks and benefits when treating women who are pregnant or planning pregnancy.
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