Risk of preterm delivery and other adverse perinatal outcomes in relation to maternal use of psychotropic medications during pregnancy

Objective

The purpose of this study was to determine the association of maternal psychotropic medication use during pregnancy with preterm delivery and other adverse perinatal outcomes.

Study Design

A cohort of 2793 pregnant women in Washington State was interviewed, and their medical files were abstracted. Logistic regression models were constructed to assess odds ratios for perinatal outcomes by use of psychotropic medications.

Results

Maternal use of benzodiazepine during pregnancy was associated with an increased risk of preterm delivery (adjusted odds ratio, 6.79; 95% confidence interval, 4.01–11.5) and with increased risks of low birthweight, low Apgar score, neonatal intensive care unit admissions, and respiratory distress syndrome. Selective serotonin receptor inhibitors were associated with preterm deliveries only among women who started treatment after the first trimester.

Conclusion

Benzodiazepine was associated highly with preterm delivery and other adverse perinatal outcomes. Well-conducted cohort studies are warranted to draw conclusions about risks and benefits of psychotropic medication use during pregnancy.

Key words: benzodiazepine, cohort, pregnancy, preterm birth, selective serotonin reuptake inhibitor (SSRI)