Up until very recently only animal studies, case reports, and two very small cohort studies were available regarding zolpidem use and pregnancy. The first study included 18 women and did not find any association between zolpidem use and risk of congenital anomalies. The second study included 45 pregnant women with psychiatric illness treated with zolpidem and found that in the zolpidem-exposed group, as compared to unexposed controls, there was an increased risk of preterm delivery (26.7% vs. 15.6%) and low birth weight (13.3% vs. 4.4%).
Additionally, the authors were unable to assess the level of adherence to the prescribed medication or take into account the severity of insomnia, both of which could have a negative impact on the pregnancy. Data on other factors, such as alcohol use, smoking status, and use of over-the-counter medications, which may have an impact on pregnancy outcomes, were not gathered.
Wang LH, Lin HC, Lin CC , Chen YH & Lin HC. Increased Risk of Adverse Pregnancy Outcomes in Women Receiving Zolpidem During Pregnancy. Clin Pharm Ther 88:3, 369-374 (2010).
The authors speculate that zolpidem and other GABAergic agonists may cause the pituitary to release higher levels of vasopressin and oxytocin, which may lead to uterine vasoconstriction in the mother based on results from animal studies. Additionally, by inhibiting the central ventilatory drive, GABAergic agonists that enter the CNS may result in respiratory depression. Both of these mechanisms may reduce blood flow to the uterus, which may have an impact on fetal growth.
Wilton LV, Pearce GL, Martin RM, Mackay FJ & Mann RD. The outcomes of pregnancy in women exposed to newly marketed drugs in general practice in England. Br J Obstet Gynaecol. 105, 882-889 (1998).
Are there any risks to my baby if the father has taken zolpidem?
There is no proof that the father’s zolpidem use will negatively affect the baby’s sperm.
What are the risks of taking zolpidem in pregnancy?
There is insufficient proof that zolpidem use during early pregnancy results in birth defects in the fetus.
Pregnant women who use zolpidem and comparable medications have a higher risk of preterm labor and low birth weight babies, according to some studies. It is not clear, though, if these were zolpidem’s direct side effects or if there were additional causes that are more typical in women who take this medication.
If taken in the weeks leading up to delivery, zolpidem can cause short-term withdrawal symptoms in the newborn baby. Because of this, a newborn may be watched for a while after birth to look for signs like jitteriness, trouble falling asleep, and breathing issues.