Use of benzodiazepines and benzodiazepine receptor agonists during pregnancy: maternal characteristics.
BACKGROUND
Use of benzodiazepine (BZD) drugs or hypnotic benzodiazepine receptor agonists (HBRAs) during pregnancy may represent a hazard for the foetus. In order to analyse this in an adequate way, knowledge of maternal characteristics as putative confounders is needed.


METHODS
In the Swedish Medical Birth Register, 2149 pregnant women using BZDs or HBRAs were identified, 1944 of them in early pregnancy. These women were compared with other women (n = 859 455) giving births during the same period (1 July 1995-31 December 2004). The following maternal characteristics were studied: age, parity, smoking habits, education, previous miscarriages, years of involuntary childlessness as an estimate of subfertility, concomitant drug use and some pregnancy complications.


RESULTS
Use and/or reporting of BZDs or HBRAs increased with maternal age. It was higher at first and 4+ parity and increased markedly with maternal smoking. Women with low education reported a higher use than women with high education. Previous miscarriage or subfertility had little impact on the use of these drugs. Preterm birth and caesarean section (also at term birth) were more common than expected. In women using BZDs or HBRAs, other types of psychoactive drugs were used in excess.


CONCLUSIONS
Women using BZDs or HBRAs differ in many aspects from women not using those drugs. These differences may act as confounders in the analysis of pregnancy outcome.
Wikner
Birgitta Norstedt
BN
Department of Medicine, Karolinska Institutet, Clinical Pharmacology Unit, Karolinska University Hospital, Solna, Stockholm, Sweden.
Stiller
Carl-Olav
CO
Källén
Bengt
B
Asker
Charlotte
C
D000022:Abortion, Spontaneous; D000293:Adolescent; D000328:Adult; D001569:Benzodiazepines / Q000009:adverse effects / Q000145:classification / Q000627:therapeutic use*; D015992:Body Mass Index; D002585:Cesarean Section / Q000706:statistics & numerical data; D036861:Delivery, Obstetric / Q000706:statistics & numerical data; D004522:Educational Status; D005260:Female; D058785:GABA-A Receptor Agonists; D006801:Humans; D006993:Hypnotics and Sedatives / Q000009:adverse effects / Q000627:therapeutic use*; D007231:Infant, Newborn; D008423:Maternal Age; D008875:Middle Aged; D009099:Multiple Birth Offspring / Q000706:statistics & numerical data; D016017:Odds Ratio; D011247:Pregnancy; D011256:Pregnancy Outcome; D012042:Registries / Q000706:statistics & numerical data; D012907:Smoking; D013548:Sweden
D058785:GABA-A Receptor Agonists; D006993:Hypnotics and Sedatives; D001569:Benzodiazepines