Can Valium and Xanax Cause Increase the Risk of Ectopic Pregnancy?

Recent studies have sparked growing concerns about the use of benzodiazepines like Xanax (alprazolam) and Valium (diazepam) during pregnancy, particularly their potential to increase the risk of complications such as ectopic pregnancies, miscarriage, and birth defects. Researchers have identified links between benzodiazepine use and adverse outcomes, including a 50% higher risk of ectopic pregnancy in women who filled prescriptions before conception, as well as neonatal complications like respiratory issues and low birth weight.

While these findings are alarming, they remain part of an ongoing investigation into the safety of benzodiazepines during pregnancy. Despite the emerging data, the exact mechanisms and broader implications of these risks are not yet fully understood, leaving patients and healthcare providers to navigate uncertain terrain when making decisions about anxiety and sleep management during pregnancy.

This article will explore the scientific evidence surrounding benzodiazepine use during pregnancy, the legal landscape regarding potential Xanax birth defect lawsuits and related claims, and the critical role of informed decision-making for women weighing the risks and benefits of these medications. Importantly, while research has raised valid safety concerns, clear guidelines are still evolving, and the focus remains on empowering women with accurate, up-to-date information to make the best choices for themselves and their children in consultation with their healthcare providers.  At the bottom of the article, we give our updated 2025 thoughts on this issue.

Normal Pregnancies vs. Ectopic Pregnancies

In a normal pregnancy, a fertilized egg will attach itself to the lining of the uterus in order to begin the growing process. However, an ectopic pregnancy will occur if the fertilized egg implants and grows outside of the main cavity of the uterus.

It most commonly occurs in one of the fallopian tubes, but occasionally an ectopic pregnancy will occur in other areas as well, such as in one of the ovaries, the abdominal cavity, or the cervix. In the case of an ectopic pregnancy, the mother is at a much higher risk of having complications that can result in a birth injury.

Benzodiazepines and Ectopic Pregnancies

In the Stanford study, researchers asked whether women who fill a benzodiazepine prescription before conception are at an increased risk of ectopic pregnancy. Using data from U.S. commercial insurance claims, researchers began a cohort study involving over 1.6 million pregnancies from November 2008 to September 2015. To identify ectopic pregnancies in women that were prescribed benzodiazepines in the 90 days before conception, they used diagnosis and procedure codes.

Benzodiazepines

Benzodiazepines are a class of drugs commonly known as tranquilizers, which are prescribed by doctors to treat anxiety, insomnia, and seizures. Brand names include Xanax, Valium, and Klonopin.

Of the 1,691,366 pregnancies, approximately 1% (almost 18,000) of the women involved had filled at least 2 benzodiazepine prescriptions before conception. There was an excess of 80 ectopic pregnancies per 10,000 pregnancies, and their IPT-weighted risk of ectopic pregnancies was 1.47 times greater for women who took benzodiazepine before conception.

What to Make of All of This?

Ultimately, the findings showed that women who took benzodiazepines like Valium or Xanax before conception had a 50% increased risk of having an ectopic pregnancy. Additionally, these women were also at a higher risk of miscarriage, birth injuries, and the child was more likely to have developmental issues.

This study was very important because the information that is produced can be used to help women and their healthcare providers make more fully informed decisions about what drugs they are taking during their reproductive years. [Get 2025 updated thoughts below.]

More Relevant Studies of Interest

1. Benzodiazepine Use and Neonatal Outcomes” by Yale School of Medicine, 2024

   A recent investigation conducted by Yale researchers examined the impact of benzodiazepine use during pregnancy on neonatal outcomes. The study followed a cohort of pregnant women who had used benzodiazepines, comparing them to a control group. Results revealed that benzodiazepine exposure was linked to a 2.5-fold increase in cesarean section rates and a threefold increase in the likelihood of infants requiring ventilatory support after birth. The researchers urged healthcare providers to weigh these risks carefully when prescribing benzodiazepines to pregnant women and to monitor fetal health closely during such pregnancies.

2. “Benzodiazepine Use During Pregnancy and Risk of Miscarriage” by JAMA Psychiatry, 2024

   This study analyzed the association between benzodiazepine use during pregnancy and the risk of miscarriage. Researchers evaluated data from a large cohort of pregnant women, focusing on those who filled benzodiazepine prescriptions before or during early pregnancy. The findings indicated that benzodiazepine use was associated with an increased risk of miscarriage, even after controlling for potential confounders, such as genetics and environmental factors. The study highlighted the need for caution when prescribing benzodiazepines to women of reproductive age and emphasized the importance of considering alternative therapies to manage anxiety or sleep disorders during pregnancy.

3. “Prevalence of benzodiazepines and benzodiazepine-related drugs exposure before, during, and after pregnancy: A systematic review and meta-analysis” by Babette Bais, et al., Journal of Affective Disorders, 2020.

Because the maternal use of benzodiazepines during pregnancy is considered fairly common, this study reviews and analyzes the use of these drugs before, during, and after pregnancy to estimate the true prevalence of the use of this drug in pregnant women. The study confirmed that the use of benzodiazepines was common in pregnant women and that the potential risks for both the mother and baby are a major concern. The study concluded that due to the commonality of benzodiazepine prescriptions for pregnant women and the potential risks of taking them, further research is necessary to ensure the short- and long-term maternal safety and explore other non-pharmacological alternative treatments.

2. “Obstetrical and neonatal outcomes after benzodiazepine exposure during pregnancy: Results from a prospective registry of women with psychiatric disorders” by Marlene P. Freeman, et al., General Hospital Psychiatry, 2018.

The goal of this study was to examine the effects of benzodiazepine use during pregnancy on both the mother and unborn baby. There were 794 women that were followed throughout their pregnancy, with data taken from maternal reports and medical records to track maternal outcomes (cesarean sections and preeclampsia) and neonatal outcomes (birth weight, difficulty breathing, difficulty feeding, prematurity, etc…). Results showed that infants exposed to benzodiazepines in utero were more likely to be admitted to the NICU, as well as more likely to have a smaller head circumference, as opposed to unexposed infants. The study also found adverse effects on the infant, such as respiratory and muscular issues.

3. “Association of Maternal Use of Benzodiazepines and Z-Hypnotics During Pregnancy With Motor and Communication Skills and Attention-Deficit/Hyperactivity Disorder Symptoms in Preschoolers” by Angela Lupattelli, Ph.D., et al., JAMA Network, 2019.

A study meant to examine the reproductive safety of maternal benzodiazepine use, and the potential long-term developmental risks it might have on children that have been exposed to it. Researchers hoped to quantify the association between the use of this drug by mothers of preschool-aged children that exhibit symptoms of motor and communication deficits, and attention-deficit hyperactivity disorder. Results showed that there was no increased risk for greater ADHD symptoms or motor deficits following intrauterine exposure to benzodiazepines at different points. However, children born to mothers that were taking these drugs late in their pregnancy did show an increased instance of greater motor and communication deficits than unexposed children.

4. “Use of benzodiazepine medications during pregnancy and potential risk for birth defects, National Birth Defects Prevention Study, 1997-2011” by Sarah C. Tinker, et al., Birth Defects Research, 2019.

This study is meant to look at the conflicting results for the association between benzodiazepine use during pregnancy and birth defects. Researchers analyzed data from the National Birth Defects Prevention Study between the years of 1997-2011 in order to assess the prevalence of factors associated with benzodiazepine use during pregnancy among mothers of infants without any birth defects. Results showed that exposure to benzodiazepines during pregnancy was rare, but may be associated with risks for certain birth defects. However, researchers did also conclude that these results should be interpreted cautiously, as they would need to be replicated to make them more concrete.

5. “Benzodiazepine Intoxication in a Neonate by Maternal Use in Pregnancy” by Bittmann S. Villalon G, Weissenstein A, and Luchter E, Journal of Clinical Cases and Reports, 2019.

This study looks at how the abuse of benzodiazepines by pregnant women can cause intoxication in the fetus. They do this because benzodiazepines can diffuse across the placenta to the fetus due to their high lipid solubility. When the placenta loses its cytotrophoblast following the 6^th month of pregnancy, the transport of benzodiazepines is further facilitated. The study looks at a newborn delivered in the 36^th week of pregnancy to a mother that used benzodiazepines, which was born “floppy, drowsy, and pulmonary impaired.”<a id=”2025″></a>

6. “Benzodiazepines in Pregnancy” by Jaye M. Shyken, et al., Clinical Observations and Gynecology, 2019.

A study that looks at the short-term neonatal effects of maternal use of benzodiazepine to treat anxiety. Both anxiety and benzodiazepine use are both associated with low birth weight and preterm delivery, while long-term effects include hypotonia, depression, and withdrawal. These long-term effects are still poorly understood. To avoid withdrawal, the study suggests that these medications be gradually tapered off. Additionally, the study looks at the pharmacology, pregnancy implications, tapering schedules, and alternative treatment strategies for anxiety.

2025 Thoughts

There is still limited research on the relationship between benzodiazepine use and the risk of ectopic pregnancy. Some studies suggest that the use of benzodiazepines, such as Valium and Xanax, during early pregnancy may increase the risk of ectopic pregnancy. However, the exact mechanisms by which benzodiazepines might contribute to this risk are not fully understood, and more research is needed to clarify the connection. So far, no new studies have definitively confirmed these findings.

As of 2025, no new conclusive studies have emerged, but researchers continue to investigate the relationship between benzodiazepine use during pregnancy and reproductive risks, including ectopic pregnancy. Until there is stronger evidence, you are unlikely to see a surge of Xanax birth defect lawsuits or claims alleging the drug causes miscarriage. The latter would also face challenges, as existing warnings, though arguably general, may provide a defense against such claims.

What should you do now? The key—again, again, again—is to talk to your doctor. Discuss the known risks and benefits thoroughly and make an informed choice based on your individual health needs and circumstances.