Maternal Use of Sedatives or Hypnotics and Infant Congenital Malformations

Abstract

Much interest has been paid to the use of sedatives and hypnotics during pregnancy, especially after the finding of the strong teratogenic capacity of thalidomide. The pattern of drug use has changed from barbiturates and meprobamates to benzodiazepines, hypnotic benzodiazepine receptor agonists, and some antihistamines. The literature on benzodiazepines is not consistent but the majority of recent studies have not identified any teratogenic effect. It is possible that some benzodiazepines may be teratogens while others are not. In the Swedish data, alprazolam shows up as a possible teratogen with a main effect on cardiovascular defects but few data on this drug exist in the literature. Other specific benzodiazepines may have a teratogenic effect, not present in the most used drugs, e.g., diazepam or oxazepam. There seems to be little reason to suspect teratogenic effects of hypnotic benzodiazepine receptor agonists or the antihistamine drugs used as sedatives or hypnotics.