Neonates/newborns depression

If anesthetics, analgesics, and hypnotics are given during labor, they can adversely affect the newborn child by inducing respiratory depression and neonatal asphyxia. 

The fatal toxic syndrome in low-birth-weight neonates, which includes symptoms of metabolic acidosis and respiratory depression, was attributed to the use of benzyl alcohol as a preservative in solutions used to flush umbilical catheters. As a result of this, the FDA has recommended that benzyl alcohol should not be used in such flushing solutions and has advised against the use of medicines containing preservatives in the newborn. ... 

Propofol Propofol has been relatively free of acute side effects other than those associated with its mechanism of action. Continuous infusions lasting greater than 10 days in ICUs have demonstrated no significant apparent toxicities. Propofol is not recommended for obstetrics, including cesarean section deliveries. It crosses the placenta, and as with other general anesthetic agents, may be associated with neonatal depression. Propofol is not recommended for use in nursing mothers because it is excreted in human milk, and the effects of oral absorption of small amounts of propofol in newborn and infants are not known. 

A variety of allergic, hepatotoxic, and hematologic reactions to the benzodiazepines may occur, but the incidence is quite low these reactions have been associated with the use of flurazepam and triazolam but not with temazepam. Large doses taken just before or during labor may cause hypothermia, hypotonia, and mild respiratory depression in the neonate. Abuse by the pregnant mother can result in a withdrawal syndrome in the newborn. 

A significant finding in the experiments of Mills (1979) was the observation that PMN from full term infants have both depressed respiratory burst activity as measured by CL and depressed bactericidal activity while ingestion remains normal. The author s results demonstrated that neonatal PMN were comparable to adult PMN in the clearance of low PMN-bacteria ratios but depressed at high ratios. CL correlated well with these observations and is important to the understanding of newborn infant susceptibility to infection. 

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