Matheson I
Tidsskr Nor Laegeforen. 1989 Aug 10;109(22):2118-22.
Hospital records were used to record, all drugs prescribed in the maternity ward, delivery characteristics and complications in both mother and infant at five university hospitals. The retrospective survey comprised 970 women and represented 10% of all vaginal deliveries in these hospitals in 1980, and 2% of all annual births in Norway. In total 90% of the women received drugs, excluding laxatives, oxytocics and long-term medication, vitamins and iron. Large variations were found between hospitals in respect of hypnotics (41-86%) and analgesics (65-95%). Of newborns 4-23% were treated with a drug. The large variation was largely due to frequent administration of naloxone at one of the hospitals. Drug utilization post partum was significantly higher in primipareas and in mothers who underwent interventions such as epidural anaesthesia, oxytocin drip, forceps delivery and tears. 98% of the babies were breast-fed on discharge and thus received milk potentially containing drugs. The frequent use of hypnotics indicates that breast-feeding mothers were treated like hospital patients in general. For the majority of the drugs used as a routine in the maternity wards there was no data or insufficient data on excretion in breast milk. The large discrepancy between hospitals as regards prescription of hypnotics and oxytocics to the mother and naloxone to the newborn was considered not to reflect rational prescription criteria and should therefore be reassessed.
医院记录用于记录五所大学医院产科病房所开的所有药物、分娩特征以及母婴并发症情况。这项回顾性调查涵盖了970名女性，占这些医院1980年所有阴道分娩的10%，占挪威全年出生人数的2%。总共有90%的女性接受了药物治疗，不包括泻药、催产药、长期用药、维生素和铁剂。不同医院在催眠药（41%-86%）和镇痛药（65%-95%）的使用方面存在很大差异。4%-23%的新生儿接受了药物治疗。这种巨大差异主要是由于其中一家医院频繁使用纳洛酮。初产妇以及接受过硬膜外麻醉、催产素点滴、产钳分娩和会阴撕裂等干预措施的母亲产后药物使用率明显更高。98%的婴儿在出院时进行母乳喂养，因此摄入了可能含有药物的乳汁。催眠药的频繁使用表明，母乳喂养的母亲总体上被当作医院病人来对待。对于产科病房常规使用的大多数药物，关于其在母乳中的排泄情况没有数据或数据不足。不同医院在给母亲开催眠药和催产药以及给新生儿开纳洛酮方面存在的巨大差异被认为没有反映出合理的处方标准，因此应该重新评估。
