Dispensing of benzodiazepines and benzodiazepine-related drugs to pregnant women: a population-based cohort study

Eur J Clin Pharmacol. 2014 Nov;70(11):1367-74. doi: 10.1007/s00228-014-1744-4. Epub 2014 Sep 11.

Abstract

Purpose: The study aimed to describe the dispensing of benzodiazepines and benzodiazepine-related drugs (z-hypnotics) to pregnant women and to study the characteristics of these women and the extent of co-medication.

Methods: A population-based cohort study was conducted based on the linkage of nationwide registries: the Medical Birth Registry of Norway and the Norwegian Prescription Database. The data covers dispensed drugs to women 3 months prior to, during and after pregnancy. The study population consisted of 345,703 singleton pregnancies during a period starting 1 April 2004 or later and ending before 1 January 2011.

Results: In 5,135 (1.5 %) of the pregnancies, the women were dispensed a benzodiazepine or z-hypnotic at least once. Of these, 68.5 % filled just one prescription for the duration of the pregnancy. Prevalence was lower in pregnancy than before and after pregnancy. The median total amount of benzodiazepines and/or z-hypnotics dispensed during pregnancy was 15 defined daily doses (DDDs), while the 25 % receiving the largest amounts got 40 DDDs or more. Five hundred eleven women, the 10 % that were prescribed the largest amounts during pregnancy, received a median amount of 220 DDDs. Women receiving these drugs were older, more often smokers, without a partner and suffering from chronic disease. Of the medicated pregnant women, 19.6 % and 19.3 % were also prescribed an opioid and antidepressant, respectively.

Conclusions: The use of benzodiazepines and z-hypnotic drugs during pregnancy was not very prevalent in Norway. However, our findings imply that there is a substantial number of pregnancies where these drugs are dispensed often and/or in large quantities and where co-medication occurred.

MeSH terms

  • Adult
  • Analgesics, Opioid / therapeutic use
  • Antidepressive Agents / therapeutic use
  • Benzodiazepines / therapeutic use*
  • Databases, Factual
  • Drug Prescriptions / statistics & numerical data*
  • Female
  • Humans
  • Hypnotics and Sedatives / therapeutic use*
  • Norway / epidemiology
  • Pregnancy / statistics & numerical data*
  • Young Adult

Substances

  • Analgesics, Opioid
  • Antidepressive Agents
  • Hypnotics and Sedatives
  • Benzodiazepines