title: Benzodiazepine use among mothers of small children: a register-based cohort study.
abstract: OBJECTIVE
  To compare benzodiazepine (BZD) purchases in different groups of mothers of small children.
  
  
  METHODS
  Prospective population-based cohort study based on the Finnish social and health care registers.
  
  
  METHODS
  Finnish women of child-bearing age.
  
  
  METHODS
  All women who gave birth in 2002 in Finland (n = 54 519).
  
  
  METHODS
  Latent class analysis (LCA) was used to create a typology of mothers according to their substance abuse status, psychiatric disorders and socio-demographic characteristics. The mothers were followed-up yearly for purchases of benzodiazepines, starting 4 years before the child's birth and continuing up to the child's 7th birthday. BZD purchases in different mother groups were compared using negative binomial hurdle models.
  
  
  RESULTS
  The five mother types identified by LCA were mothers with substance abuse (1%), mothers with psychiatric disorders (1%), mothers with a risk of social marginalization (11%), mothers with minor social problems (18%) and mothers with no identified problems (69%; the comparison group). Mothers with substance abuse problems had the highest odds of purchasing BZDs [odds ratio OR = 27.5, 95%CI = 22.9-33.0; RR = 20.2, 95%CI = 14.9-27.3. The change in time was similar in all groups: the probability of purchasing and the number of purchases were lowest during pregnancy and the year of the child's birth.
  
  
  CONCLUSIONS
  In Finland, among mothers of young children, prevalence of benzodiazepine use is reduced during pregnancy and the child's first year, and then increases as the child grows older. Mothers with substance abuse and psychiatric disorders are at particularly high risk of benzodiazepine use.
authors.affiliation: National Institute for Health and Welfare, Helsinki, Finland.
authors.forename: Kirsimarja
authors.initials: K
authors.lastname: Raitasalo
authors.forename: Marja
authors.initials: M
authors.lastname: Holmila
authors.forename: Ilona
authors.initials: I
authors.lastname: Autti-Rämö
authors.forename: Jaana E
authors.initials: JE
authors.lastname: Martikainen
authors.forename: Veli-Matti
authors.initials: VM
authors.lastname: Sorvala
authors.forename: Pia
authors.initials: P
authors.lastname: Mäkelä
mesh_terms: D000328:Adult; D000437:Alcoholism / Q000453:epidemiology*; D001569:Benzodiazepines / Q000627:therapeutic use*; D015331:Cohort Studies; D005260:Female; D005387:Finland / Q000453:epidemiology; D006801:Humans; D001523:Mental Disorders / Q000453:epidemiology; D009035:Mothers / Q000706:statistics & numerical data*; D016017:Odds Ratio; D015995:Prevalence; D011446:Prospective Studies; D012042:Registries; D062487:Social Marginalization; D019966:Substance-Related Disorders / Q000453:epidemiology
chemical_list: D001569:Benzodiazepines
keywords: Benzodiazepines; motherhood; register studies; substance abuse