Journal of epidemiology · 2026
Hypnotics use during pregnancy and the risks of preterm birth, low birth weight, and major congenital malformations: The Japan Environment and Children's Study.
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Takeuchi Yoshinori, Adomi Motohiko, Ueda Nagisa, Kawakami Chihiro, Ito Shuichi, Goto Atsushi, Japan Environment and Children’s Study (JECS) Group
Аннотация
BACKGROUND: The effects of hypnotics use on the risk of adverse pregnancy outcomes across pregnancy trimesters are underexplored.
METHODS: From the data of the Japan Environment and Children's Study (JECS), we constructed cohorts of women registered between January 2011 and March 2014 who delivered a liveborn singleton child. Exposure to hypnotics during the first (Period 1) and second/third (Period 2) trimesters was assessed in interviews. We identified the outcomes, preterm birth, low birth weight, and major congenital malformations, based on medical record transcripts. For each exposure period and pregnancy outcome, we estimated the risk differences (RDs) and risk ratios (RRs) using modified least-squares and modified Poisson models, respectively, adjusting for the mother's age, body mass index, lifestyle factors, comorbidities, and other medication use.
RESULTS: A total of 91,370 and 80,089 women were included for Periods 1 and 2, respectively. For Period 2, an increased risk of preterm birth (RD: 0.0748, 95% confidence interval [CI] 0.0175-0.132; RR 2.57 95%CI 1.42-4.65) and low birth weight (RD 0.0661 95%CI 0.00204-0.130; RR 1.77 95%CI 1.10-2.85) were observed among exposed compared with unexposed individuals. These risks were not observed for Period 1. The risk of major congenital malformations was not increased for both Periods 1 and 2.
CONCLUSION: Hypnotic medication in late-stage pregnancy may increase the risks of preterm birth and low birth weight, although caution is warranted because of possible confounding by indication. The elevation of the risk of the usage of hypnotics at any stage of pregnancy on major malformations was not observed.
METHODS: From the data of the Japan Environment and Children's Study (JECS), we constructed cohorts of women registered between January 2011 and March 2014 who delivered a liveborn singleton child. Exposure to hypnotics during the first (Period 1) and second/third (Period 2) trimesters was assessed in interviews. We identified the outcomes, preterm birth, low birth weight, and major congenital malformations, based on medical record transcripts. For each exposure period and pregnancy outcome, we estimated the risk differences (RDs) and risk ratios (RRs) using modified least-squares and modified Poisson models, respectively, adjusting for the mother's age, body mass index, lifestyle factors, comorbidities, and other medication use.
RESULTS: A total of 91,370 and 80,089 women were included for Periods 1 and 2, respectively. For Period 2, an increased risk of preterm birth (RD: 0.0748, 95% confidence interval [CI] 0.0175-0.132; RR 2.57 95%CI 1.42-4.65) and low birth weight (RD 0.0661 95%CI 0.00204-0.130; RR 1.77 95%CI 1.10-2.85) were observed among exposed compared with unexposed individuals. These risks were not observed for Period 1. The risk of major congenital malformations was not increased for both Periods 1 and 2.
CONCLUSION: Hypnotic medication in late-stage pregnancy may increase the risks of preterm birth and low birth weight, although caution is warranted because of possible confounding by indication. The elevation of the risk of the usage of hypnotics at any stage of pregnancy on major malformations was not observed.