Benzodiazepines For Anxiety Safe To Take During Pregnancy?

Self-reported anxiety is prevalent among 24.6 percent of women in the third trimester, according to an extensive review of 783 articles from 34 countries. In the European Union (EU), if approximately 5 million births are due every year, researchers from the University of Oslo estimated that since 1.5 to 3 percent of pregnant women consume benzodiazepines (BZD) as anti-anxiety medication, roughly about 100,000 babies are vulnerable to the drugs’ side effects. 

They studied 95,200 mothers from 1999 to 2008 with the goal of eventually being able to provide potential mothers of the future more information to make the right choices, since there is insufficient research on this important topic at present. Their study was first published in the Public Library of Science (PLOS) journal. a peer-reviewed journal with open access, on June 6.

Based on their research, the most popular medication among pregnant women were oxazepam and diazepam ( BZD-anxiolytic variety) as well as zopiclone ( z-hypnotics variety) to ease anxiety and insomnia. While pregnant during week 17 and week 30, the mothers responded to survey questions on maternal health, medication and socioeconomic background.

They were subjected to another round of questioning six months after child delivery. After this portion of the research was completed, they were given questionnaires about their children at three intervals. The first one was at 18 months, the next at 3 years old and, finally, at 5 years old. 

All the questions were answered on the basis of self-assessment. The data was uploaded to the Medical Birth Registry of Norway (MBRN) through their personal identification codes. The registry has information on the delivery, complications at birth and health records of the children. The Norwegian Institute of Public Health commissioned a mother and child cohort study with participants enrolled over a decade, who consented in all the cases.   

Out of the huge sample size that was expected to participate, only 36,401 completed all stages of the study and responded promptly whenever contacted. The results of the study showed 275 children were exposed to anti-anxiety medication during gestation. Internalized and externalized sociological and neuro-development problems were then examined.

The former deals with social isolation, feeling sad, being irritable and having stomach aches — all of which are internalized problems not obvious to everyone. External behavioural issues pertain to bullying, aggression, disobeying rules and the like. Though harmless during their childhood years, these habits can follow them when they reach adulthood. 

pregnant A new study by University of Oslo found that women who take anti-anxiety medication during pregnancy could potentially psychologically impair their children by the tender age of 5. Pixabay

Internalized issues were not surprisingly more common among children who were exposed to BZDs or z-hypnotics in the womb. In this category, of the 35,629 children took all three stages of the survey, 267 children were exposed to anti-anxiety medication. From them, 44 or 16.5 percent showed symptoms of internalized behavioural issues at the age of 5. 

In comparison, 3,692 or 10 percent of the entire sample who completed the survey manifested internalized issues at age 5. The researchers concluded that taking anti-anxiety tablets during gestation puts the child at a higher risk of developing internalized behavioural problems. 

Meanwhile, the survey on external behavioural problems was completed by 35,284 participants till the age of 5. It was found that 261 children were exposed to anxiety medication in gestation. Of them, 43 or 16. 5 percent displayed signs of external behavioural issues. Among those children who were not exposed, about 3,484 (9.9 percent) showed externalized behavioural problems. 

The study could not concretely conclude that taking anti-anxiety pills are bad for the fetus post-birth because its development could be affected by other factors. For example, when someone is prescribed a BZD tablet, it is to sometimes compliment antipsychotic medications and antidepressants only as a mild sedative, so the dosage involved could be potentially small and not harmful to begin with. 

Mothers on such medication stereotypically could also be indulging in drinking, smoking, drugs and opioid addiction, to name a few self-destructive habits. The researchers were clear that the difference is very small because of the various biases involved — one being the mother’s perception of bad behavior, the others are the self-reporting of BZD dosages by the mothers and the thought that the sample size is comparatively larger than older studies. However, the study did not include details about specific trimesters among other details.