Concepts on the use of hypnotics before and after infertility or pregnancy

Classification of sleeping pills

Class BZD	FDA Rating
Alprazolam (Xanax)	D
Diazepam (valium)	D
Lorazepam (Ativan)	D
Z Series
Zaleplon (Sonaplon)	C
Zolpidem (Stenos)	C
Zopiclone (Imovane)	C
Antihistamine
Diphenhydramine	B
Doxylamine	A
Hydroxyzine	C

 

Effects of Zolpidem on a Pregnant Embryo or Baby

◉ At 5-10 times the highest dose of zolpidem, there was no pharmacotoxicity to mouse or rabbit baby embryos, and teratogenicity was not observed at any of the doses.

◉ However, in the zolpidem ultra-high dose group (doses equivalent to 10-20 times the recommended maximum human dose), there was an increase in fertilized egg implantation failure.

◉ The use of zolpidem for more than 90 days during pregnancy is associated with lighter birth weight, preterm labor, and cesarean section. However, there was no significant difference in the rate of teratogenesis.

◉ There is no evidence that taking Stillnox reduces fertility in men or women.

Zolpidem is classified as Class C in the FDA pregnancy classification. Animal studies have found that zolpidem may cause teratogenicity or embryonic damage, and it is not known whether it will have the same effect in humans. It is not known whether it will have the same effect on human beings. Therefore, this drug is not absolutely contraindicated in pregnant women and should be used with caution on balance. 

◉ Stillnox is not recommended during pregnancy because little is known about its effects on the baby.

 

AtivanEffects on the Pregnant Embryo or Baby

◉ Abnormalities found in rabbit studies are associated withAtivanThe dosage is not relevant. At doses above 40 mg/kg, there was an increased incidence of stillbirths in rabbit babies, which did not occur at lower doses. It is not recommended to take the dose during the first trimester of pregnancy.Ativan. During the first three months of useAtivanMay increase congenital malformations.

◉ BZD analogs may be associated with preterm labor and lower baby weight.

◉ Few studies have linked Ativan to cleft lip.

◉ Ativan use during embryo implantation has no significant effect on pregnancy rates or live birth rates.

◉ The use of Ativan during embryo transfer has not demonstrated a significant effect on reproductive outcomes, including live birth rates, suggesting that it has a limited effect on IVF success.

  

Conclusion

Women who sleep less than 6 hours a day are prone to hormonal imbalance and ovarian dysfunction.

◉ All sleeping pills pass through the placenta and are accessible to the baby. Be aware of withdrawal symptoms after birth. The baby may need to be hospitalized for a few days after birth for additional monitoring.

◉ Sleeping pills taken during pregnancy and breastfeeding may have adverse effects on the fetus through the bloodstream or lactation.

◉ Insomnia before and after pregnancy It is recommended to use Antihistamines (FDA Grade A or B) first, which is safer.

◉ Insomnia is so severe that you need a sleeping pill. Consider using a Z-series sleeping pill such as EndoTinos (FDA classified C drug).

◉ Sleeping medications in the BZD category (FDA Classification D drugs) are not recommended.

◉ Sleeping pills taken before and after pregnancy should be changed to a more appropriate medication in consultation with your doctor.

◉ Provide a comfortable, relaxing environment for patients and try various ways to support mom's pregnancy through family and friends.