Ontwenning bij de pasgeborene na blootstelling aan psychofarmaca tijdens de zwangerschap

Stand van zaken
Noera Kieviet, Koert Dolman, Hanneke Wennink, Marion Heres en Adriaan Honig

Withdrawal in newborns after exposure to psychotropic medications during pregnancy

Conflict of interest: A. Honing has research grants at the Dutch Kidney Foundation and Fonds Nuts Ohra pending. Financial support: none declared.

  • The use of psychotropic medications during pregnancy causes withdrawal symptoms in 20-30% of the newborns.

  • The literature on withdrawal symptoms is not unanimous concerning their recognition and treatment.

  • A search of PubMed and Embase revealed 198 articles in which potential withdrawal symptoms in newborns were described following exposure to psychotropic medications during pregnancy.

  • Commonly occurring withdrawal symptoms are mostly mild, including restlessness and sleeping and feeding difficulties. Severe symptoms such as convulsions are rare.

  • It can sometimes be difficult to differentiate between symptoms of intoxication and symptoms of withdrawal.

  • The Finnegan scale is widely used to recognise withdrawal from psychotropic medication. An observation period of at least 48 h post-partum is advised. Recognition of withdrawal is important to prevent needless additional tests.

  • In withdrawal symptoms supportive measures such as feeding on demand and swaddling are usually sufficient. If withdrawal symptoms are severe, phenobarbital is a therapeutic option.