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EXPERT REACTION: Anxiety meds during early pregnancy associated with increased risk of miscarriage

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Canadian researchers have found an association between the use of benzodiazepines - which include drugs such as Xanax and Valium - during early pregnancy and miscarriage. The researchers examined around 442,000 pregnancies from 1998 to 2015 and among these, 6.1 per cent ended in miscarriage, 1.4 per cent of which occurred among women taking benzos in early pregnancy.

Journal/conference: JAMA Psychiatry

Link to research (DOI): 10.1001/jamapsychiatry.2019.0963

Organisation/s: Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG), The Australian National University, Centre Hospitalier Universitaire Sainte-Justine, Canada

Media Release

From: JAMA

Association Between Incident Exposure to Benzodiazepines in Early Pregnancy and Risk of Spontaneous Abortion

Bottom Line: Benzodiazepines are a class of drugs used to treat anxiety, insomnia and mood disorders. This observational study examined the risk of miscarriage associated with their use in early pregnancy by drug class, specific agent and short- or long-acting formulation in about 442,000 pregnancies in Canada from 1998 through 2015. Among the pregnancies, 27,000 (6.1 percent) ended in miscarriage and 1.4 percent of those miscarriages were among women who used benzodiazepines in early pregnancy. The study reports any benzodiazepine use during early pregnancy was associated with increased risk of miscarriage. A limitation of the study is its lack of information on alcohol use by the women, which could have influenced the results. These findings suggest physicians should carefully evaluate the risks and benefits of prescribing benzodiazepines in early pregnancy since alternative treatments exist.

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Expert Reaction

These comments have been collated by the Science Media Centre to provide a variety of expert perspectives on this issue. Feel free to use these quotes in your stories. Views expressed are the personal opinions of the experts named. They do not represent the views of the SMC or any other organisation unless specifically stated.

Professor Julie Quinlivan is from the School of Medicine at The Australian National University (ANU) and University of Notre Dame

This is an important study. Clinicians need to be careful prescribing benzodiazepines at any time, but especially in pregnancy where the drugs can cross the placenta and affect the developing baby. There are only a few indications for prescribing benzodiazepines on the Pharmaceutical Benefits Scheme (PBS). For many patients there are alternative medications that can be used that do not lead to drug dependency. Often non-drug treatment options exist.

If a clinician identifies a pregnant woman is using benzodiazepines in early pregnancy, they should seek advice from a specialist in order to identify alternative treatment options.

Last updated: 16 May 2019 11:12am

Declared conflicts of interest:

Julie is Director of the Professional Services Review, the Commonwealth Statutory Agency responsible for ensuring compliance with Australia's MBS and PBS schemes.

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