Newborn withdrawal syndrome

A withdrawal syndrome occurs in the newborn of dependent mothers. It is important not to attempt to reduce the mother s use of opioid late in pregnancy, as a more severe and unpredictable neonatal withdrawal syndrome may result. 

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. 

D. Use in pregnancy. FDA category D (possible fetal risk). Pentobarbital readily crosses the placenta, and chronic use may cause hemorrhagic disease of the newborn (owing to vitamin K deficiency) or neonatal dependency and withdrawal syndrome. However, these potential effects do not preclude its acute, short-term use for a seriously symptomatic patient (see p 405). 

All of the CNS depressants can pass through the placenta. Newborn babies with dependent mothers may be physically dependent themselves and have withdrawal symptoms that include tremors, irritability, hyperactivity, and feeding and breathing problems. There may be birth defects such as fetal alcohol syndrome, which consists of abnormal facial features, a small head, mental retardation, and poor coordination. 

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