Association Between Attention-Deficit/Hyperactivity Disorder and Benzodiazepines and Z-Hypnotics in Pregnancy—Questions Remain

The study by Sundbakk et al 1 found no increased risk of attention-deficit/hyperactivity disorder (ADHD) in offspring who were exposed to benzodiazepines or z-hypnotics in utero after analyzing data from the Norwegian Mother, Father and Child Cohort Study (MoBA). Among the 82201 pregnant individuals with live births included in the study, 0.8% self-reported any use of benzodiazepines or z-hypnotics in at least one 4-week interval throughout the pregnancy. Offspring were followed up for a mean period of 11.3 years through a linkage to the Norwegian national registries for diagnosis of hyperkinetic disorders or a prescription for an ADHD medication. The authors' primary analysis considered the timing of exposure (early or middle and/or late pregnancy) compared with pregnant individuals without benzodiazepine or z-hypnotic exposure during pregnancy among all pregnancies and among pregnancies with documented indications (depression, anxiety, sleeping problems, or other mental health conditions). Additionally, the authors examined the association between the number of exposed intervals during pregnancy and ADHD. Results suggested no association of benzodiazepine or Z-hypnotic use with childhood ADHD; however, an increased risk with use in 2 or more 4-week intervals compared with only 1 exposed interval could not be ruled out.