Journal Club: Benzodiazepine Use in Pregnancy and Competing Pregnancy Outcomes R620

Course Summary

This Journal Club reviews a nationwide cohort study published in JAMA Internal Medicine evaluating benzodiazepine use during pregnancy using a target trial emulation framework. By aligning exposure with gestational timing and accounting for abortion and stillbirth as competing events, the study addressed key biases present in prior research. Apparent protective associations for preterm birth in live-birth–only analyses reversed once competing pregnancy losses were considered, revealing increased risks. Associations were more pronounced with second-trimester exposure. Although relative risks were elevated, absolute risk differences were modest, underscoring the importance of balanced interpretation.

Course Format

Homestudy

Course Syllabus

• Introduction
• Benzodiazepine Use During Pregnancy
  • Methods
  • Results
  • Discussion
• Summary

Authors

Richard Daniels, PharmD, BCPS

Richard “Cole” Daniels earned his Doctor of Pharmacy(PharmD) from the Skaggs School of Pharmacy at the University of Montana in 2018. Throughout pharmacy school he completed a 3-year internship at Community Medical Center in Missoula, Montana in which he gained valuable experience in an acute care setting. Cole currently serves as a psychiatric clinical staff pharmacist at the Montana State Hospital. He has over 11 years of pharmacy experience having worked in several settings including retail, acute care, and inpatient psychiatric care. Cole has a diverse set of interests. However, acute care medicine, infectious disease, pain management, and asthma/COPD are a primary focus of his at the Montana State Hospital. He obtained board certification as a certified pharmacotherapy specialist in the Spring of 2022.

Elisabeth Gordon, BScPharm, RPh

Elisabeth Gordon earned her BSc(Pharm) from the University of British Columbia in 2004. After graduation, she worked in community retail pharmacies on Vancouver Island, before returning to her rural hometown of Salmon Arm. In 2016 and 2017, Elisabeth trained with Pallium Canada and Victoria Hospice to enhance her knowledge of end-of-life-care and palliative services. She is a volunteer medical supervisor for T1DOutreach, a peer support platform for adults living with type 1 diabetes, and a member of a Canadian peer support group for adults living with Birdshot Uveitis. Elisabeth enjoys working in a small, fast-paced rural pharmacy where she brings compassion and empathy to her everyday practice.