Benzodiazepine Use Early in Pregnancy and Risk for Congenital Malformations.

First-trimester benzodiazepine exposure is not associated with a significant increase in major congenital malformations, with a pooled adjusted RR of 0.99 (95% CI, 0.96 to 1.03).

• Why it matters: Understanding the safety of benzodiazepine use during early pregnancy is crucial due to conflicting existing data on malformation risks, impacting clinical decision-making for pregnant persons.
• What they did: A population-based cohort study analyzed over 4 million pregnancies from U.S. Medicaid and MarketScan databases, comparing pregnancies with at least one benzodiazepine fill in the first trimester to unexposed pregnancies, using propensity score weighting to control confounders.
• The result: The study found no consistent evidence of increased risk for any major or organ-specific malformations associated with benzodiazepine exposure, although some analyses of coexposure suggested possible associations that require further investigation.