Recent studies show that cases of autism spectrum disorder (ASD) and attention deficit/hyperactivity disorder (ADHD) associated with prenatal exposure to benzodiazepines may be caused by maternal genetic confounding .
Psychiatric disorders such as depression and anxiety disorders are reported in 10% to 30% of pregnant women. Benzodiazepines are sometimes used to reduce symptoms of anxiety and depression, with a global prevalence of 1.9% of her.
Concern about benzodiazepine use because benzodiazepines can cross the placenta, have been found in amniotic fluid and breast milk, and the U.S. Food and Drug Administration classification indicates that they may harm the fetus is occurring.
Researchers hypothesized that maternal depressive or anxiety disorders that lead to prescribing benzodiazepines may be partially responsible for the development of neurodevelopmental disorders in children. and depressive symptoms are associated with neurodevelopmental disorders in offspring.
To determine the association between benzodiazepine exposure during pregnancy and the development of ASD and ADHD, researchers conducted a study consisting of human patients approved by the Research Ethics Committee of China Medical University and Hospital.
Children born at term between 1 January 2004 and 31 December 2017 were included in the study. Benzodiazepine prescriptions included long-acting and short-acting benzodiazepines as well as anatomical therapeutic chemical classification codes beginning with N05BA.
Prescribing information was used to determine maternal benzodiazepine exposure before and during pregnancy, and a link to the Taiwan Maternal and Child Health Database collected data on the child, his father, and his father’s exposure to benzodiazepines. it was done.
Benzodiazepine exposure was recorded for all three trimesters. First trimester was defined as within 90 days after probable conception, second trimester as between 91 and 180 days after gestation, and third trimester as between 181 and 270 days after gestation. Delivery date and gestational age were used to estimate the date of conception.
Incidence of ASD and ADHD was measured in children exposed to benzodiazepines during pregnancy and in children not exposed to benzodiazepines during pregnancy. At least one admission record or three outpatient diagnoses were used to determine ASD and ADHD.
Child covariates included gestational age, date of birth, low-income family status, and reproductive history. Maternal covariates included nationality, maternal smoking during pregnancy, index birth age, maternal opioid medication use, and history of psychiatric disorders.
Analyzes were restricted to mothers with anxiety disorders or major depressive disorder. Associations between paternal benzodiazepine exposure and neurobehavioral outcomes were analyzed through sibling comparisons.
The study included 1,516,846 children under the age of 14, 1,138,732 biological mothers, and 1,134,320 fathers. Prenatal exposure to benzodiazepines was found in 5% of children, 4.6% in first trimester, 2.2% in third trimester, and 0.6% in third trimester.
Overall mean follow-up was 8.5 years. ASD and ADHD were more common among individuals exposed to benzodiazepines during pregnancy, with 1.1% of exposed children developing ASD compared to 0.9% of unexposed children and those exposed. 4.9% of exposed children developed ADHD compared to 3.9% of unexposed children.
Benzodiazepine exposure was associated with an increased risk of developing ASD and ADHD in all three stages. Covariates more frequently seen in cases of prenatal benzodiazepine exposure included low-income family status, maternal opioid use, smoking during pregnancy, and maternal and paternal psychiatric disorders.
Sibling comparisons showed no significant association between prenatal benzodiazepine exposure and the development of ASD or ADHD. Analyzes were limited to mothers with anxiety disorders or major depressive disorder, and children born to these mothers who were not prenatally exposed to benzodiazepines were found to have a similar likelihood of developing ASD and ADHD. rice field.
These results showed an increased risk of ASD and ADHD in children born after benzodiazepine exposure during pregnancy, but no significant increased risk when compared with sibling controls. maternal genetic or environmental factors may contribute to the association between benzodiazepine exposure and risk of ASD and ADHD.
reference
Chen VC, Wu S, Lin C, Lu M, Chen Y, Stewart R. Association of prenatal exposure to benzodiazepines with development of autism spectrum and attention-deficit/hyperactivity disorder. JAMA net opened. 2022;5(11):e2243282.doi:10.1001/jamanetworkopen.2022.43282
