Highlights
- •Most withdrawal symptoms are mild in neonates of women taking psychotropic drugs.
- •The risk is increased when a mother is administered with multiple drugs.
- •Breastfeeding may be protective against withdrawal symptoms.
Abstract
Objectives
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.
Study Design
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.
Results
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.
Conclusions
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.
Keywords
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Article info
Publication history
Published online: September 23, 2020
Accepted:
September 4,
2020
Received in revised form:
September 3,
2020
Received:
April 13,
2020
Identification
Copyright
© 2020 Elsevier B.V. All rights reserved.
