妊娠晚期服用地西泮对新生儿的影响

来源 :世界核心医学期刊文摘(儿科学分册) | 被引量 : 0次 | 上传用户:shengli1011
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Introduction. -Since benzodiazepines (BZD) are largely prescribed during pregnancy, the Regional Pharmacovigilance Center (RPVC) of Tours regularly deals with questions about the risk of their administration to pregnantwomen and the monitoring of the newborns exposed in utero to these drugs. During the third trimester, we recommend a switch in the BZD maternal treatment to oxazepam, which has an intermediary half-life and no active metabolite, and a hospitalisation of the newborn in order to monitor his respiratory rate. The purpose of our study was to evaluate the neonatal consequences of BZD used at the end of pregnancy and to analysed if our recommendations were taken into account and if they were appropriate. Methods. -From 1989 to the end of 2002, we studied the files in which women had received a BZD during the 30 days prior to delivery. We analysed maternal treatments, the outcome of pregnancy and the development of the newborn, the therapeutically attitude recommended and whether or not it was respected. Results. -A total of 73 files were selected. Seventy neonates were born to 73 women. The newborns were hospitalised (73% ) and they developed adverse reactions possibly related to the use of BZD (51,5% ) : an impregnation syndrome (42% ) characterized by hypotonia and hypoventilation, and a with drawal syndrome (20% ) with tremulations as the main symptom. Conclusion. -Considering the most frequent neonatal manifestations, hospitalization and the respiratory monitoring recommended by the RPVC seemed adequate. However, the switch to oxazepam was seldom done and its advantages should be pointed out. -Since benzodiazepines (BZD) are largely prescribed during pregnancy, the Regional Pharmacovigilance Center (RPVC) of Tours connectedograms with questions about the risk of their administration to pregnantwomen and the monitoring of the newborns exposed in utero to these drugs. During the third trimester, we recommend a switch in the BZD maternal treatment to oxazepam, which has an intermediary half-life and no active metabolite, and a hospitalisation of the newborn in order to monitor his respiratory rate. The purpose of our study was to evaluate the neonatal consequences of BZD used at the end of pregnancy and to analysed if our recommendations were taken into account and if they were appropriate. Methods. -From 1989 to the end of 2002, we studied the files in which women have received a BZD during the 30 days prior to delivery. We analysed maternal treatments, the outcome of pregnancy and the development of the newborn, the therapeutically attitude recommended and wheth Seventy neonates were born to 73 women. The newborns were hospitalised (73%) and they produce adverse reactions possibly related to the use of BZD (51,5 %): an impregnation syndrome (42%) characterized by hypotonia and hypoventilation, and a with drawal syndrome (20%) with tremulations as the main symptom. Conclusion. -Considering the most frequent neonatal manifestations, hospitalization and the respiratory monitoring recommended by the RPVC seemed adequate. However, the switch to oxazepam was seldom done and its advantages should be pointed out.
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