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• Posted December 28, 2023

Xanax, Valium in Pregnancy May Raise Miscarriage Risk

A class of sedatives called benzodiazepines, which include meds like Ativan, Valium and Xanax, could be linked to higher odds for miscarriage if taken during pregnancy, new research finds.

The findings held even after accounting for possible confounding factors such as anxiety and insomnia, the Taiwanese research team said.

Looking at data on about 3 million pregnancies, "we found that benzodiazepine use during pregnancy was associated with an approximately 70% increased risk of miscarriage," wrote a team led by Fei-Yuan Hsiao at Taiwan University's Graduate Institute of Clinical Pharmacy.

Based on the findings, they urge that doctors "meticulously balance" the risks and benefits of benzodiazepines whenever they consider prescribing the drugs to pregnant women who are dealing with insomnia or other psychiatric issues.

In the new study, miscarriage was defined as loss of pregnancy between the first prenatal visit with a doctor (typically around the 8th week of gestation) and before the 20th week.

Hsiao's group looked at data from over 3 million pregnancies among Taiwanese women, out of which 4.4% resulted in a miscarriage.

Focusing on the women's prescription drug use during pregnancy, the study found that using a benzodiazepine boosted the odds for miscarriage by 69%.

That number was "consistent" regardless of confounding factors and the duration of benzodiazepine use.

The study was published Dec. 27 in the journal JAMA Psychiatry.

Hsiao's group also pointed to the results of a prior British study. It found that miscarriage rates were 60% higher among women who took a benzodiazepine while pregnant, compared to women who had psychiatric issues that might warrant use of the drugs (for example depression or anxiety) but who were not prescribed one.

According to the research team, benzodiazepines "can readily cross the placental barrier and accumulate substantially in embryo and fetal tissues." In turn, that potentially "may cause fetal developmental abnormalities, ultimately leading to miscarriage," they said.

The study was not designed to prove cause-and-effect and the absolute risk of miscarriage to any one woman remains low.

Nevertheless, Hsiao's team believes that "prescribing benzodiazepines should only be considered following a comprehensive evaluation of the potential risks and benefits for both the mother and the child."

More information

Find out more about miscarriage at the March of Dimes.

SDOURCE: JAMA Psychiatry, Dec. 27, 2023