Prospective assessment of pregnancy outcome: RESULTS(1)

Pregnancy outcome was ascertained for 137 cases of BDZ exposure and a similar number of controls. The daily dose of BDZ ingested during gestation ranged from 0.07 to 202 mg/day. Monotherapy was the norm; the majority (88%) of women took only one BDZ and the remainder (16 women) used two. The types of BDZ ingested by the 137 women, as ascertained during the interview with the patient, are listed in Table 1, the indications for ingestion in Table 2 and patterns of fetal exposure in Table 3. buy flovent inhaler

 

 

TABLE 1 Use of benzodiazepines, as reported by patients

Benzodiazepine	Number*
Alprazolam	17
Bromazepam	7
Chlordiazepoxide	4
Clonazepam	13
Diazepam	43
Flurazepam	5
Lectopam	1
Lorazepam	33
Nitrazepam	1
Oxazepam	4
Temazepam	1
Triazolam	15

*The total is 144 (n=137) because some women used more than one type of benzodiazepine

TABLE 2 Reported indications for benzodiazepine use

Indication		Number
Agoraphobia		2
Anxiety and/or stress		47
Benzodiazepine abuse		1
Car accident		1
Cardiovascular
Palpitations		1
Initial valve prolapse		2
Depression		11
Drug rehabilitation therapy		1
Headache/migraine		6
Heartburn		1
Hiatal hernia		1
Insomnia		22
Nervous breakdown		2
Obsessive compulsive disorder		1
Panic attacks		8
Procedures		1
General anesthesia		2
Tooth extraction		1
Surgery		1
Myelogram		1
Intravenous pyelogram
Psychosis		1
Seizure		2
Sore jaw		1
Weight loss therapy with methamphetamine		1
Unknown/not given		17
Total		135

TABLE 3  Gestational age at exposure to various benzodiazepines

Fetal exposure	Number (%)*
First day of LMP to 13 weeks	127/137 (93%)
14-26 weeks only	3/137 (2.2%)
First day of LMP to delivery	23/137 (17%)
First day of LMP to 14 weeks	2/137 (1.4%)
First day of LMP to 16 weeks	1/137 (0.7%)
First day of LMP to 20 weeks	1/137 (0.7%)
First day of LMP to 25 weeks	1/137 (0.7%)
First day of LMP to 28 weeks	1/137 (0.7%)
First day of LMP to 31 weeks	1/137 (0.7%)
First day of LMP to 33 weeks	1/137 (0.7%)
16 to 39 weeks	1/137 (0.7%)

*Percentages add to more than 100 because some women took more than one benzodiazepine more than once during pregnancy. LMP Last menstrual period

Ninety-three per cent of women (127/ 137) took BDZ in the first trimester only (defined as the time from the first day of the last menstrual period [LMP] to the end of the 13th week postconception); 2% took BDZ in the second trimester only (defined as the time from 14 to 26 weeks postconception). Seventeen per cent of women took BDZ throughout the entire pregnancy. Although the majority of women took BDZ as the only psychoactive agent, 13 women (9.5%) concurrently ingested tricyclic antidepressants; amitriptyline (three women), clomipramine (two), desipramine (three), fluoxetine (one), imipramine (three) and trazodone (one). All BDZ cases were in cluded in the com para tive analy sis be cause the authors re -cently es tab lished that tri cyclic an ti de pres sants do not in -crease the baseline rate for major malformations. The three most common voluntarily reported indications for BDZ use were anxiety and stress, in som nia and de pression. The most preferred BDZ was diazepam (n=43), followed by lor-azepam (n=33) and alprazolam (n=17).

Category: Benzodiazepines

Tags: Benzodiazepines, Fetus, Pregnancy