Golub M S, Eisele J H, Donald J M
California Primate Research Center, University of California, Davis.
Dev Pharmacol Ther. 1991;16(4):231-40.
The endogenous opiate system is thought to play a unique role in the adaptive response to hypoxia during the fetal and neonatal period. Exogenous opiates used as analgesics during labor may also affect this adaptive response. Infant monkeys (Macaca mulatta) were exposed to oxygen deprivation (15-min period breathing 12% O2) on the day of birth. One half of the infants had been exposed to meperidine during parturition via treatment of the dam (2 mg/kg, i.v.). An additional control group received neither treatment. All infants were evaluated for growth, development and neurobehavioral performance over a subsequent 14-week period. Compared to controls, infants exposed to oxygen deprivation had somewhat slower weight gains during the early neonatal transition from weight loss to weight gain, were less responsive to sensory stimulation on the day of the oxygen deprivation episode, slept more on the first night after the episode, had fewer active and mature behaviors during a 3-week period of rapid motor development, and had impaired fine motor skills. Prior exposure to labor analgesia apparently prevented many of these effects. Use of opiate drugs during the perinatal period needs to take into account the unique properties and functions of the endogenous opiate system during this developmental period.
内源性阿片系统被认为在胎儿和新生儿期对缺氧的适应性反应中发挥独特作用。分娩期间用作镇痛药的外源性阿片类药物也可能影响这种适应性反应。出生当天，将幼猴（恒河猴）暴露于缺氧环境（呼吸12%氧气15分钟）。一半的幼猴在分娩期间通过对母猴进行治疗（静脉注射2mg/kg）接触了哌替啶。另一个对照组未接受任何治疗。在随后的14周内，对所有幼猴的生长、发育和神经行为表现进行评估。与对照组相比，暴露于缺氧环境的幼猴在新生儿早期从体重减轻到体重增加的过渡阶段体重增加略慢，在缺氧发作当天对感觉刺激的反应较弱，发作后第一晚睡得多，在快速运动发育的3周内主动和成熟行为较少，并且精细运动技能受损。产前接触分娩镇痛显然预防了许多这些影响。围产期使用阿片类药物需要考虑到这一发育阶段内源性阿片系统的独特特性和功能。
