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Benzodiazepines in Pregnancy
Jaye M Shyken1, Shilpa Babbar1, Shaweta Babbar2
1St. Louis University School of Medicine, St. Louis, Missouri.
Clinical Obstetrics and Gynecology
|January 11, 2019
Summary
Benzodiazepine use is increasing, especially during pregnancy, posing risks like preterm birth and low birth weight. Gradual tapering is recommended to manage withdrawal and explore alternative anxiety treatments.
Area of Science:
- Pharmacology and Toxicology
- Obstetrics and Gynecology
- Neonatal Health
Background:
- Rising rates of benzodiazepine use and associated mortality, particularly with opioid co-prescription.
- Anxiety disorders are common and frequently treated with benzodiazepines, with increasing co-occurrence during pregnancy.
- Benzodiazepine use in pregnancy is linked to adverse neonatal outcomes, including preterm delivery and low birth weight.
Purpose of the Study:
- To review the pharmacology and pharmacokinetics of benzodiazepines.
- To discuss the implications of benzodiazepine use during pregnancy.
- To outline recommended tapering schedules and alternative anxiety management strategies.
Main Methods:
- Literature review of pharmacology, pharmacokinetics, and clinical studies.
- Analysis of data on benzodiazepine effects in pregnant populations and neonates.
- Synthesis of information on withdrawal management and alternative therapies.
Main Results:
- Benzodiazepines are associated with physical dependence and serious withdrawal symptoms.
- Neonatal effects include hypotonia, depression, and withdrawal, with long-term sequelae poorly understood.
- Tapering benzodiazepine use is advised to mitigate withdrawal risks.
Conclusions:
- Benzodiazepine use during pregnancy requires careful consideration due to potential risks to mother and child.
- Effective management strategies, including gradual tapering and alternative treatments, are crucial.
- Further research is needed to understand long-term neonatal outcomes.
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