Kanemura Akari, Masamoto Hitoshi, Kinjo Tadatsugu, Mekaru Keiko, Yoshida Tomohide, Goya Hideki, Aoki Yoichi
Department of Obstetrics and Gynecology, Graduate School of Medicine, University of the Ryukyus, 207 Uehara Nishihara, Okinawa, 903-0215, Japan.
Department of Obstetrics and Gynecology, Graduate School of Medicine, University of the Ryukyus, 207 Uehara Nishihara, Okinawa, 903-0215, Japan.
Eur J Obstet Gynecol Reprod Biol. 2020 Nov;254:226-230. doi: 10.1016/j.ejogrb.2020.09.008. Epub 2020 Sep 24.
Neonates delivered by women who were taking psychotropic or anticonvulsant drugs during pregnancy are at increased risk of developing neonatal withdrawal syndrome. We investigated the incidence of neonatal withdrawal symptoms and the effects of multiple maternal medications and breastfeeding on neonatal withdrawal symptoms.
This study examined the overall incidence of neonatal withdrawal symptoms in neonates delivered from 2004 to 2016 by women who were taking oral antipsychotics, antidepressants, anxiolytics, sedatives, or anticonvulsant drugs during pregnancy. Moreover, we compared the incidence of neonatal symptoms between mothers taking single drugs and multiple drugs, and between breastfed and formula-fed neonates. We scored the neonates according to the neonatal withdrawal syndrome checklist created by Isobe et al., which is widely used in Japan.
We examined 131 mothers and their 134 neonates. Withdrawal symptoms were found in 54.5 % of neonates. Symptoms were found in 32.4 % of neonates delivered by mothers taking single drugs and 62.9 % of neonates delivered by mothers taking two or more drugs (p = 0.0019). One or more withdrawal symptoms developed in 46.4 % of breastfed neonates and 66.1 % of formula-fed neonates (p = 0.034). Five infants had a score of 8 or more points on the withdrawal checklist, which is an indication to consider treatment with pharmacotherapy. All five of these neonates were mainly formula-fed, and their mothers were taking two or more drugs.
The incidence of withdrawal symptoms was high in neonates delivered by women taking psychotropic or anticonvulsant drugs; however, there were few serious cases. The risk increased when a mother was taking multiple drugs. Breastfeeding appeared to protect against withdrawal symptoms.
孕期服用精神药物或抗惊厥药物的女性所分娩的新生儿发生新生儿戒断综合征的风险增加。我们调查了新生儿戒断症状的发生率以及多种母体药物和母乳喂养对新生儿戒断症状的影响。
本研究调查了2004年至2016年期间孕期服用口服抗精神病药、抗抑郁药、抗焦虑药、镇静剂或抗惊厥药物的女性所分娩新生儿的新生儿戒断症状总体发生率。此外，我们比较了服用单一药物和多种药物的母亲所分娩新生儿的症状发生率，以及母乳喂养和配方奶喂养新生儿的症状发生率。我们根据日本广泛使用的矶部等人创建的新生儿戒断综合征检查表对新生儿进行评分。
我们检查了131名母亲及其134名新生儿。54.5%的新生儿出现了戒断症状。服用单一药物的母亲所分娩的新生儿中有32.4%出现症状，服用两种或更多药物的母亲所分娩的新生儿中有62.9%出现症状（p = 0.0019）。46.4%的母乳喂养新生儿和66.1%的配方奶喂养新生儿出现了一种或多种戒断症状（p = 0.034）。五名婴儿在戒断检查表上的得分达到8分或更高，这表明需要考虑药物治疗。所有这五名新生儿主要是配方奶喂养，他们的母亲服用了两种或更多药物。
服用精神药物或抗惊厥药物的女性所分娩的新生儿戒断症状发生率较高；然而，严重病例较少。母亲服用多种药物时风险增加。母乳喂养似乎可以预防戒断症状。
