Safety of Alprazolam Use in Pregnancy in Western Australia: A Retrospective Cohort Study Using Linked Health Data

Figures & data

Table 1. Characteristics of women treated with alprazolam during pregnancy compared with pregnant women who had used alprazolam prior to pregnancy and pregnant women who had never used alprazolam.

	Alprazolam: Pregnancy	Alprazolam: pre-pregnancy	P-value	Non-alprazolam^1	P-value
Number	48	96	-	96	-
Maternal age, mean ± sd	31.6 ± 5.2	31.3 ± 5.1	.735	31.4 ± 5.3	.848
Smoking <20 weeks, n (%)	22 (45.8%)	43 (44.8%)	.906	46 (46.9%)	.906
Smoking ≥20 weeks, n (%)	20 (41.7%)	33 (37.5%)	.629	35 (36.5%)	.545
Previous pregnancies, median (IQR)	3 (1, 4)	2 (1, 3)	.407	2 (1, 3)	.240
Maternal diabetes, n (%)	6 (12.5%)	12 (12.5%)	>.999	15 (12.5%)	.502
Metropolitan area^1, n (%)	43 (89.6%)	78 (81.3%)	.204	74 (77.1%)	.077
SEIFA advantage, n (%)
1 (greatest disadvantage)	6 (12.5%)	14 (14.6%)	.920	13 (13.5%)	.828
2	9 (18.8%)	17 (17.7%)		13 (13.5%)
3	15 (31.3%)	29 (3.2%)		35 (36.5%)
4	10 (2.8%)	19 (19.8%)		21 (21.9%)
5 (greatest advantage)	7 (14.9%)	17 (17.7%)		14 (14.6%)

Sd = standard deviation, SEIFA = socio-economic indexes for area.

¹Major cities of Australia (i.e. Perth) based on the Remoteness Area Classification for the year closest to the year of birth.

Table 2. Maternal, labor, and delivery outcomes in women treated with alprazolam during pregnancy compared with pregnant women who had used alprazolam prior to pregnancy and pregnant women who had never used alprazolam.

	Alprazolam: Pregnancy	Alprazolam: pre-pregnancy	P-value	Non-alprazolam^a	P-value
Mental health hospitalizations
Pre-conception (5 years)	15 (31.3%)	21 (21.9%)	.222	9 (9.4%)	.002
During pregnancy	19 (39.6%)	17 (17.7%)	.005	8 (8.3%)	.001
Postpartum (day 0–42)	<5 (<1.4%)	<5 (<5.2%)	.220	<5 (<5.4%)	.114
Labour and delivery
Onset of labor
Spontaneous	18 (37.5%)	32 (31.3%)	-	41 (42.7%)	-
Induced	15 (31.3%)	37 (38.5%)	.441	36 (37.5%)	.977
No labor	15 (31.3%)	27 (28.1%)	.900	19 (19.8%)	.189
Caesarian section, n (%)	23 (47.9%)	33 (34.4%)	.118	30 (31.3%)	.052
Threatened abortion, n (%)	<5 (<1.4%)	<5 (<5.2%)	-	<5 (<5.2%)	-
Threatened pre-term labor, n (%)	0 (.0%)	<5 (<5.2%)	-	5 (5.2%)	-
Pre-eclampsia, n (%)	<5 (<1.4%)	<5 (<5.2%)	-	<5 (<5.2%)	-
Antepartum hemorrhage, n (%)	5 (1.4%)	<5 (<5.2%)	NS	<5 (<5.2%)	NS
Postpartum hemorrhage, n (%)	0 (.0%)	<5 (5.2%)	-	<5 (<5.2%)	-

^aNS = not significant, where the presence of a p-value may indicate the value of a cell size less than 5.

Table 3. Characteristics and outcomes of neonates prenatally exposed to alprazolam compared with non-exposed neonates, whose mothers had been dispensed alprazolam prior to pregnancy or had never been dispensed alprazolam.

	Alprazolam: Pregnancy	Alprazolam: pre-pregnancy	P-value	Non-alprazolam^a	P-value
Number	48	96	-	96	-
Sex (male), n (%)	23 (47.9%)	43 (44.8%)	.723	41 (42.7%)	.553
Birth weight (grams), mean ± sd	3,121 ± 643	3,214 ± 595	.379	3,153 ± 581	.762
Percentage of birth weight, mean ± sd	93.0 ± 14.4	99.3 ± 2.0	.026	95.3 ± 11.4	.415
Low birth weight for gestational age, n (%)	11 (22.9%)	6 (6.3%)	.006	8 (8.3%)	.019
Birth weight < 2,500 g, n (%)	6 (12.5%)	10 (1.4%)	.708	11 (11.5%)	.855
Birth length (cm), mean ± sd	48.9 ± 3.2	49.3 ± 3.7	.567	49.4 ± 3.2	.425
Percentage of birth length, mean ± sd	98.2 ± 4.7	99.6 ± 4.8	.099	99.6 ± 4.6	.096
Head circumference (cm), mean ± sd	34.0 ± 1.8	33.9 ± 2.4	.935	33.8 ± 2.1	.585
Percentage of head circumference, mean ± sd	98.5 ± 4.2	99.4 ± 5.1	.266	98.3 ± 4.1	.820
Est. gestation (weeks), mean ± sd	38.1 ± 1.8	38.0 ± 2.4	.753	38.2 ± 2.3	.875
Pre-term (<37 weeks), n (%)	<5 (<1.4%)	10 (1.4%)	NS	12 (12.5%)	NS
Perinatal mortality, n (%)	0 (.0%)	<5 (<5.2%)	-	0 (.0%)	-
Apgar scores < 7 at 5 min, n (%)	<5 (<1.4%)	<5 (<5.2%)	>.999	<5 (<5.2%)	.482
Neonatal abstinence syndrome, n (%)	<5 (<1.4%)	5 (5.2%)	NS	<5 (<5.2%)	NS
Floppy baby syndrome, n (%)	0 (.0%)	<5 (<5.2%)	-	<5 (<5.2%)	-
Infant respiratory distress syndrome, n (%)	<5 (<1.4%)	6 (6.3%)	.609	6 (6.3%)	.609
Neonatal LOS (days), median (IQR)	4 (2, 5)	3 (2, 4.5)	.186	3 (1, 4)	.981
Admission to the special care unit, n (%)	9 (18.8%)	19 (19.8%)	.882	19 (19.8%)	.882

^aIQR = interquartile range, LOS = length of stay, n = number, NS = not significant (where the presence of a p-value may indicate the value of a cell size less than 5), st = standard deviation.