Benzodiazepines and Z-Drugs in Pregnancy
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The use of benzodiazepines (BZDs) during pregnancy has been considered for a long time at high risk of inducing some structural birth defects, particularly oral cleft. The aim of this chapter is to briefly present the best recent studies focusing on the risks of major malformations (MMs) and perinatal complications (PCs) in newborns of pregnant women exposed to BZDs and Z-drugs during pregnancy. In the current literature, there is a substantial agreement that BZD exposure during the first trimester of pregnancy seems not to be associated with an increasing risk of MMs. However, during the second and third trimester of pregnancy, BZD exposure may be associated with some neonatal adverse reactions, such as a withdrawal syndrome and an infant floppy syndrome. No increase in the risk of neurobehavioral and/or cognitive disorders in infants exposed during pregnancy has been observed in the few studies focusing on this issue. Less information concerning the foetal and neonatal safety of Z-drug exposure during pregnancy has been so far published; however, the few data available have not reported an increased risk of MMs and neonatal adverse outcomes in infants exposed in utero to these drugs.
General principles in prescribing and clinical recommendations on the management of BZDs and Z-drugs during pregnancy are provided, according to the recent suggestions coming from the international guidelines and expert opinions.
KeywordsBenzodiazepines Z-drugs Clinical psychopharmacology Pregnancy Congenital malformations Perinatal complications
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