MedicalResearch.com Interview with:
Dr. Angela Lupattelli, PhD
School of Pharmacy
University of Oslo
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Between 1-4% of pregnant women take at least once a benzodiazepine and/or a z-hypnotic medication during the course of gestation. These medications are generally used intermittently in pregnancy, mainly for treatment of anxiety disorders and sleeping problems, which are not uncommon conditions among pregnant women.
However, data regarding the safety of benzodiazepine and/or a z-hypnotic in pregnancy on child longer-term development are sparse. For instance, studies on child motor skills are only available up to toddler age, and little is known in relation to other child developmental domains. So, there is an urgent need to better understand whether prenatal use of benzodiazepine and/or a z-hypnotic medication may pose detrimental longer-term child risks.
MedicalResearch.com: What should readers take away from your report?
Response: Children born to women taking benzodiazepine/z-hypnotic medication in mid or late pregnancy did not present greater ADHD symptoms or fine motor deficits at preschool-age, compared to children not exposed to these medications during gestation.
When examining risks for gross motor and communication deficits, we observed a moderate increased risk for these child outcomes, specifically when women took benzodiazepine and/or a z-hypnotic medication in late gestation; however, the magnitude of this risk was not to the extent that the child impairment was of clinical relevance.
It is important to note that the greater risk for child gross motor and communication deficits was only found in children born to women with depressive/anxiety disorders, but not to those with sleeping or pain-related disorders. This may suggest that other factors related to maternal underlying psychiatric disorder or higher dosage regimens among these women may, at least in part, explain the observed risks between benzodiazepine/z-hypnotic medication in late pregnancy and child gross motor and communication deficits.
MedicalResearch.com: What recommendations do you have for future research as a result of this work?
Response: This study did not have information about the dosage of benzodiazepine/z-hypnotic medication taken by women during pregnancy, and examined children at preschool-age. It is important to further examine the association between cumulative dose of benzodiazepine and/or z-hypnotic use in pregnancy and child developmental outcomes, and not least evaluate child outcomes at later age.
MedicalResearch.com: Is there anything else you would like to add?
Response: This study is the first to report on the longer-term safety of benzodiazepine/z-hypnotic medication in pregnancy on child development, considering time-varying severity of maternal depressive/anxiety symptoms during pregnancy. I would like to add that women should be empowered to develop an evidence-based understanding of both potential risks and benefits of medication treatment in pregnancy in order to optimize maternal–child health.
This project is funded through Dr Nordeng’s European Research Council’s Starting Grant “Drugs in Pregnancy” (grant 639377
Lupattelli A, Chambers CD, Bandoli G, Handal M, Skurtveit S, Nordeng H. Association of Maternal Use of Benzodiazepines and Z-Hypnotics During Pregnancy With Motor and Communication Skills and Attention-Deficit/Hyperactivity Disorder Symptoms in Preschoolers. JAMA Netw Open. 2019;2(4):e191435. doi:10.1001/jamanetworkopen.2019.1435
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