"No substantial evidence that prenatal exposure to benzodiazepines or Z-hypnotics increases the risk of psychiatric disorders in children."
Study Finds No Link Between Common Sleep Aids in Pregnancy and Child Psychiatric Disorders
A large-scale South Korean study published in The BMJ offers reassuring findings for expectant mothers. The research, which analyzed data from nearly 3.8 million children, found no significant increase in the risk of psychiatric or neurodevelopmental disorders—including ADHD and autism—in children whose mothers took benzodiazepines or Z-hypnotics during pregnancy.
How the Research Was Conducted
The study drew on South Korea's National Health Information Database, covering children born between 2010 and 2022. Researchers compared three groups:
- Pregnancies exposed to benzodiazepines or Z-hypnotics
- Unexposed pregnancies (no use during pregnancy)
- Past users (women who used the drugs before, but not during, pregnancy)
Twelve specific disorders were assessed, including substance use disorder, schizophrenia, intellectual disability, autism, and ADHD. The analysis controlled for key factors such as mother's age, income, and underlying medical conditions.
Key Findings
- Initial small elevations in risk disappeared after researchers adjusted for shared family, genetic, and environmental factors using sibling analyses.
- Some modest elevated estimates were observed for:
- Early and late pregnancy exposure
- Longer durations of Z-hypnotic use
- However, the overall evidence does not support a substantial increased risk for any of the twelve disorders assessed.
Important Limitations
The study's authors caution that this observational research cannot establish causation, and that prescriptions may not reflect actual medication use. The follow-up period (up to 14 years) may be insufficient to capture late-onset conditions like schizophrenia. The study was specific to psychiatric outcomes and did not assess overall drug safety.
Expert Commentary
An accompanying editorial in The BMJ noted the findings are reassuring, but cautioned that sedatives should still be prescribed carefully. Doctors should consider the risks of prolonged use or late pregnancy exposure while balancing the risks of untreated maternal psychiatric illness.