Abstract
Using prescription drugs during pregnancy is challenging and approached with caution. In this study, we present population-based information on prescription patterns of benzodiazepines and benzodiazepine-related drugs in the peripartum period. A population-based study of 1,154,817 pregnancies between 1997 and 2015 in Denmark, of which 205,406 (17.8%) pregnancies in women with a psychiatric history. Prescription drugs starting with Anatomical Therapeutic Chemical codes N05BA, N05CD, and N05CF from 12 months before pregnancy to 12 months following pregnancy were identified. We used generalised estimating equations to estimate the adjusted 5 year risk difference in the proportion of women redeeming benzodiazepines from 1 year to 5 years after. Logistic regression was used to analyze the association between characteristics and discontinuation of benzodiazepines during pregnancy. The prevalence of benzodiazepine prescriptions was 1.9% before pregnancy, 0.6% during pregnancy, and 1.3% after pregnancy. In women with a psychiatric history, the prevalence was 5–6 times higher. A significant decrease in prescriptions to women with a psychiatric history was observed, which was less profound among women with no psychiatric history. Approximately 90% of women discontinue benzodiazepines during pregnancy, with a higher percentage of women discontinuing from 1997 to 2015. The observed decrease is likely explained by changing treatment guidelines.
Highlights
The use of prescription drugs during pregnancy is approached with caution by both pregnant women and their health care professionals, weighting both fetal and maternal health
Despite this caution, prescribed medication use is common during pregnancy, with estimations of 27–93% of pregnant women using prescription drugs (Daw et al, 2011), including benzodiazepines
The effects of benzodiazepines are mediated through the inhibitory neurotransmitter gamma-aminobutyric acid (GABA) (D'Hulst et al, 2009)
Summary
The use of prescription drugs during pregnancy is approached with caution by both pregnant women and their health care professionals, weighting both fetal and maternal health. Despite this caution, prescribed medication use is common during pregnancy, with estimations of 27–93% of pregnant women using prescription drugs (Daw et al, 2011), including benzodiazepines. Benzodiazepines have anxiolytic, hypnotic, anticonvulsant, and muscle relaxant properties, which can relieve symptoms in the short term (D'Hulst et al, 2009; Donoghue and Lader, 2010). Benzodiazepines are highly addictive and guidelines advice against long term use (Ashton, 1994; Nelson and Chouinard, 1999)
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