Zolpidem (Ambien®) in pregnancy: placental passage and outcome
- 561 Downloads
To examine the extent and clinical sequelae of fetal exposure to zolpidem, a commonly prescribed hypnotic agent. Pregnant women with psychiatric illness participating in a study of psychotropic pharmacokinetics were included. Zolpidem concentrations were analyzed in maternal and umbilical cord plasma collected at delivery. Outcomes were compared between the zolpidem-exposed group and a 1:1 matched comparator group. Forty-five women taking zolpidem during pregnancy were studied. Rates of preterm delivery and low birth weight were 26.7% and 15.6% respectively in the zolpidem-exposed group versus 13.3% and 4.4% in the matched comparator group, but no significant differences were found. The ratio of umbilical cord to maternal plasma zolpidem concentrations in 6 pairs ranged from 0.48 to 2.75. Zolpidem crosses the human placenta and rapidly clears the fetal circulation. Pregnant women with psychiatric illness treated with zolpidem may have less optimal obstetrical outcome, though it is unclear if this was related to the medication.
KeywordsPlacental passage Pregnancy Zolpidem
Supported by NIH grant MH-68036 (to ZNS).
Ms. Juric and Ms. Galanti have received salary support from NIH. Dr. Newport has received research support from Eli Lilly, GlaxoSmithKline (GSK), Janssen, and Wyeth as well as NARSAD and NIH, and speaker’s honoraria from Astra-Zeneca, Eli Lilly, GSK, and Pfizer. Dr. Ritchie has received research support from GSK and has served on advisory boards for CeNeRx Pharma, and Abaxis. Dr. Stowe has received research support from GSK, NIH, and Wyeth, served on advisory boards for Wyeth, BMS and GSK, and received speakers’ honoraria from Eli Lilly, GSK, Pfizer, and Wyeth.
- Physicians Desk Reference (2009) (PDR 61st ed). Thomson, Montvale, pp 2692–2701Google Scholar
- Stowe ZN, Ragan K (2008) ACOG practice bulletin: clinical management guidelines for obstetrician-gynecologists. Bulletin number 92, April 2008. Use of psychiatric medications during pregnancy and lactation. Obstet Gynecol 111(4):1001–1020Google Scholar