{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T14:51:44Z","timestamp":1786978304472,"version":"build-2736575974"},"reference-count":72,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2024,6,19]],"date-time":"2024-06-19T00:00:00Z","timestamp":1718755200000},"content-version":"vor","delay-in-days":18,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pharmacoepidemiology and Drug"],"published-print":{"date-parts":[[2024,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>The use of benzodiazepines and Z\u2010hypnotics during pregnancy has raised significant concerns in recent years. However, there are limited data that capture the prescription patterns and predisposing factors in use of these drugs, particularly among women who have been long\u2010term users of benzodiazepines and Z\u2010hypnotics before pregnancy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This population\u2010based cohort study comprised 2\u2009930\u2009988 pregnancies between 2004 and 2018 in Taiwan. Women who were dispensed benzodiazepines or Z\u2010hypnotics during pregnancy were identified and further stratified into groups based on their status before pregnancy: long\u2010term users (with a supply of more than 180\u2009days within a year), short\u2010term users (with a supply of less than 180\u2009days within a year), and nonusers. Trends in the use of benzodiazepines or Z\u2010hypnotics and concomitant use with antidepressants or opioids were assessed. Logistic regression models were utilized to identify factors associated with use of these drugs during pregnancy, and interrupted time series analyses (ITSA) were employed to evaluate utilization patterns of these drugs across different pregnancy\u2010related periods.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The overall prevalence of benzodiazepine and Z\u2010hypnotic use was 3.5% during pregnancy. Among prepregnancy long\u2010term users, an upward trend was observed. The concomitant use of antidepressants or opioids among exposed women increased threefold (from 8.6% to 23.1%) and sixfold (from 0.3% to 1.7%) from 2004 to 2018, respectively. Women with unhealthy lifestyle behaviors, such as alcohol abuse (OR 2.48; 95% CI, 2.02\u20133.03), drug abuse (OR 10.34; 95% CI, 8.46\u201312.64), and tobacco use (OR 2.19; 95% CI, 1.96\u20132.45), as well as those with psychiatric disorders like anxiety (OR 6.99; 95% CI, 6.77\u20137.22), insomnia (OR 15.99; 95% CI, 15.55\u201316.45), depression (OR 9.43; 95% CI, 9.07\u20139.80), and schizophrenia (OR 21.08; 95% CI, 18.76\u201323.69), and higher healthcare utilization, were more likely to use benzodiazepines or Z\u2010hypnotics during pregnancy. ITSA revealed a sudden decrease in use of benzodiazepines and Z\u2010hypnotics after recognition of pregnancy (level change \u22120.55 percentage point; 95% CI, \u22120.59 to \u22120.51). In contrast, exposures to benzodiazepines and Z\u2010hypnotics\u00a0increased significantly after delivery (level change 0.12 percentage point; 95% CI, 0.09 to 0.16).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In this cohort study, an increased trend of benzodiazepine and Z\u2010hypnotic use during pregnancy among prepregnancy long\u2010term users, as well as concomitant use with antidepressants or opioids were found. The findings have highlighted the existence of various risk factors associated with the use of these drugs during pregnancy. Utilization patterns varied across different stages of pregnancy, highlighting the need for prescription guidelines and educational services for women using these drugs during pregnancy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/pds.5847","type":"journal-article","created":{"date-parts":[[2024,6,19]],"date-time":"2024-06-19T23:39:18Z","timestamp":1718840358000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Prescription Patterns and Predisposing Factors of Benzodiazepine and Z\u2010Hypnotic Use During Pregnancy: A Nationwide Cohort Study"],"prefix":"10.1002","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8095-2965","authenticated-orcid":false,"given":"Lin\u2010Chieh","family":"Meng","sequence":"first","affiliation":[{"name":"Graduate Institute of Clinical Pharmacy, College of Medicine National Taiwan University  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chih\u2010Wan","family":"Lin","sequence":"additional","affiliation":[{"name":"Taiwan Drug Relief Foundation  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui\u2010Min","family":"Chuang","sequence":"additional","affiliation":[{"name":"Graduate Institute of Clinical Pharmacy, College of Medicine National Taiwan University  Taipei Taiwan"},{"name":"Taiwan Drug Relief Foundation  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi\u2010Yung","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology MacKay Memorial Hospital  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chi\u2010Yung","family":"Shang","sequence":"additional","affiliation":[{"name":"Department of Psychiatry National Taiwan University Hospital, and College of Medicine  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chia\u2010Yi","family":"Wu","sequence":"additional","affiliation":[{"name":"School of Nursing, College of Medicine National Taiwan University  Taipei Taiwan"},{"name":"Department of Nursing National Taiwan University Hospital  Taipei Taiwan"},{"name":"Taiwanese Society of Suicidology, Taiwan Suicide Prevention Center  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2387-8508","authenticated-orcid":false,"given":"Liang\u2010Kung","family":"Chen","sequence":"additional","affiliation":[{"name":"Center for Healthy Longevity and Aging Sciences National Yang Ming Chiao Tung University  Taipei Taiwan"},{"name":"Center for Geriatrics and Gerontology Taipei Veterans General Hospital  Taipei Taiwan"},{"name":"Taipei Municipal Gan\u2010Dau Hospital Managed by Taipei Veterans General Hospital  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1660-9120","authenticated-orcid":false,"given":"Fei\u2010Yuan","family":"Hsiao","sequence":"additional","affiliation":[{"name":"Graduate Institute of Clinical Pharmacy, College of Medicine National Taiwan University  Taipei Taiwan"},{"name":"School of Pharmacy National Taiwan University  Taipei Taiwan"},{"name":"Department of Pharmacy National Taiwan University Hospital  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,6,19]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.65.7.805"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/sleep\/27.7.1405"},{"issue":"10","key":"e_1_2_11_4_1","article-title":"Anxiety Disorders During Pregnancy: A Systematic Review","volume":"75","author":"Goodman J. 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