Editing Benzodiazepine (section)

===Pregnancy===
{{See also|Long-term effects of benzodiazepines#Neonatal effects|l1=Effects of benzodiazepines on newborns}}

In the United States, the [[Food and Drug Administration (United States)|Food and Drug Administration]] has categorized benzodiazepines into either [[Pregnancy category|category D or X]] meaning potential for harm in the unborn has been demonstrated.<ref>{{cite book |vauthors=Roach SS, Ford SM |title=Introductory Clinical Pharmacology |chapter-url=https://archive.org/details/introductoryclin0000roac |chapter-url-access=registration |edition=8th |year=2006 |publisher=Lippincott Williams & Wilkins |isbn=978-0-7817-7595-3 |page=[https://archive.org/details/introductoryclin0000roac/page/236 236] |chapter=Sedatives and hypnotics }}</ref>

Exposure to benzodiazepines during pregnancy has been associated with a slightly increased (from 0.06 to 0.07%) risk of [[cleft lip and palate|cleft palate]] in newborns, a controversial conclusion as some studies find no association between benzodiazepines and cleft palate. Their use by expectant mothers shortly before the delivery may result in a [[floppy infant syndrome]]. Newborns with this condition tend to have [[hypotonia]], [[hypothermia]], [[lethargy]], and breathing and feeding difficulties.<ref name=ACOG>{{cite journal | title = ACOG Practice Bulletin No. 92: Use of Psychiatric Medications During Pregnancy and Lactation | journal = Obstetrics and Gynecology | volume = 111 | issue = 4 | pages = 1001–1020 | date = April 2008 | pmid = 18378767 | doi = 10.1097/AOG.0b013e31816fd910 | author1 = ACOG Committee on Practice Bulletins--Obstetrics}}</ref><ref name=pmid9748174>{{cite journal | vauthors = Dolovich LR, Addis A, Vaillancourt JM, Power JD, Koren G, Einarson TR | title = Benzodiazepine use in pregnancy and major malformations or oral cleft: meta-analysis of cohort and case-control studies | journal = [[BMJ]] | volume = 317 | issue = 7162 | pages = 839–843 | date = September 1998 | pmid = 9748174 | pmc = 31092 | doi = 10.1136/bmj.317.7162.839 }}</ref> Cases of [[neonatal withdrawal syndrome]] have been described in infants chronically exposed to benzodiazepines [[Uterus|in utero]]. This syndrome may be hard to recognize, as it starts several days after delivery, for example, as late as 21 days for chlordiazepoxide. The symptoms include [[tremor]]s, [[hypertonia]], [[hyperreflexia]], [[hyperactivity]], and vomiting and may last for up to three to six months.<ref name=ACOG/><ref name=pmid9614425>{{cite journal | author = American Academy of Pediatrics Committee on Drugs | title = Neonatal drug withdrawal. American Academy of Pediatrics Committee on Drugs | journal = Pediatrics | volume = 101 | issue = 6 | pages = 1079–1088 | date = June 1998 | doi = 10.1542/peds.101.6.1079 | pmid = 9614425 | url = http://pediatrics.aappublications.org/cgi/reprint/101/6/1079.pdf }}</ref> Tapering down the dose during pregnancy may lessen its severity. If used in pregnancy, those benzodiazepines with a better and longer safety record, such as [[diazepam]] or [[chlordiazepoxide]], are recommended over potentially more harmful benzodiazepines, such as [[temazepam]]<ref>[http://www.rxlist.com/restoril-drug/warnings-precautions.htm Temazepam-Rxlist Pregnancy Category]@</ref> or [[triazolam]]. Using the lowest effective dose for the shortest period of time minimizes the risks to the unborn child.<ref>{{cite journal | vauthors = Iqbal MM, Sobhan T, Ryals T | title = Effects of commonly used benzodiazepines on the fetus, the neonate, and the nursing infant | journal = Psychiatric Services | volume = 53 | issue = 1 | pages = 39–49 | date = January 2002 | pmid = 11773648 | doi = 10.1176/appi.ps.53.1.39 | doi-access = free | title-link = doi }}</ref>