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Efectos de la exposición a las benzodiazepinas durante la vida fetal
1Department of Clinical Pharmacology, Karolinska Institute, Huddinge Hospital, Sweden.
Lancet (London, England)
|September 19, 1992
Resumen
Las dosis altas de benzodiazepinas durante el embarazo pueden estar relacionadas con defectos de nacimiento. Sin embargo, esta asociación se confunde con el abuso frecuente de alcohol y sustancias en las madres, lo que sugiere que puede no ser únicamente debido a la exposición a las benzodiazepinas.
Área de la Ciencia:
- Obstetricia y Ginecología.
- La pediatría es la medicina de los niños.
- Farmacología Farmacología.
Sus antecedentes:
- Informes anteriores sugirieron un vínculo entre el uso de dosis altas de benzodiazepinas en el embarazo y los resultados adversos del feto como el dismorfismo y el retraso mental.
- El potencial teratogénico de las benzodiazepinas requiere una mayor investigación, especialmente teniendo en cuenta los factores de confusión.
Objetivo del estudio:
- Investigar la asociación entre el uso de benzodiazepinas durante el embarazo y los resultados fetales.
- Evaluar la incidencia de anomalías congénitas y otros resultados adversos en la descendencia expuesta a altas dosis de benzodiazepinas.
Principales métodos:
- Un gran estudio de cohorte de 104.000 embarazos registrados con Medicaid (seguro de salud público de los Estados Unidos) de 1980-1983.
- Los resultados fetales se evaluaron a través de los datos de las declaraciones de salud de la descendencia hasta 6-9 años después del parto.
- Concéntrese en 80 embarazos con 10 o más recetas de benzodiazepinas, analizando el abuso de sustancias y la utilización de la atención médica que ocurren al mismo tiempo.
Principales resultados:
- Entre 80 embarazos con uso intenso de benzodiazepinas, se identificaron 3 muertes intrauterinas y 2 bebés con anomalías congénitas (lo que sugiere muerte neonatal).
- De 64 niños sobrevivientes vinculados, 6 tenían diagnósticos consistentes con anomalías teratogénicas.
- Los registros maternos indicaron un uso intensivo de la atención médica, el consumo frecuente de alcohol y el abuso de sustancias, lo que complica el aislamiento de los efectos de las benzodiazepinas.
Conclusiones:
- Se observó una alta tasa de teratogenicidad en embarazos con uso intenso de benzodiazepinas maternas.
- La teratogenicidad observada se produjo junto con múltiples exposiciones a alcohol y sustancias, lo que indica que estos factores pueden confundir o causar las anomalías, en lugar de las benzodiazepinas solas.
- Se necesita más investigación para desentrañar los efectos de las benzodiazepinas del uso de otras sustancias en el embarazo.
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