Confirmation of gestational exposure to alprazolam by analysis of biological matrices in a newborn with neonatal sepsis.
BACKGROUND
Different biological matrices are suitable for drug testing in newborns presenting with an acute withdrawal syndrome.


METHODS
The newborn of a mother reporting alprazolam use during pregnancy presented with respiratory distress and clinical features consistent with neonatal withdrawal syndrome or neonatal sepsis of vertical transmission. Alprazolam and its main metabolite (alpha-hydroxyalprazolam) were detected in cord serum, neonatal urine and also in neonatal hair, meconium and placenta, accounting for both acute and chronic exposure to this benzodiazepine during intrauterine life. At the same time, the clinical diagnosis of neonatal sepsis was confirmed by isolation of Streptococcus agalactiae from otic cultures. The infant received oxygen therapy and antibiotic treatment and recovered completely at the age of 11 days. Although no congenital anomalies or behavioral alterations were diagnosed during hospitalization, periodic follow-ups were requested to check for potential long-term effects of prenatal exposure to alprazolam.
García-Algar
Oscar
O
Servicio de Pediatría, Hospital Universitari del Mar, Barcelona, Spain.
López-Vílchez
M Angeles
MA
Martín
Itziar
I
Mur
Antonio
A
Pellegrini
Manuela
M
Pacifici
Roberta
R
Rossi
Silvia
S
Pichini
Simona
S
D000328:Adult; D000525:Alprazolam / Q000009:adverse effects* / Q000032:analysis; D014151:Anti-Anxiety Agents / Q000009:adverse effects* / Q000032:analysis; D003937:Diagnosis, Differential; D005260:Female; D005312:Fetal Blood / Q000737:chemistry; D006197:Hair / Q000737:chemistry; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D018811:Maternal Exposure / Q000009:adverse effects*; D008431:Maternal-Fetal Exchange; D008470:Meconium / Q000737:chemistry; D009357:Neonatal Abstinence Syndrome / Q000175:diagnosis* / Q000503:physiopathology; D010102:Oxygen Inhalation Therapy; D010920:Placenta / Q000737:chemistry; D011247:Pregnancy; D018805:Sepsis / Q000175:diagnosis* / Q000382:microbiology / Q000628:therapy; D013290:Streptococcal Infections / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology; D013292:Streptococcus agalactiae / Q000302:isolation & purification; D015813:Substance Abuse Detection / Q000379:methods; D016896:Treatment Outcome; D014556:Urine / Q000737:chemistry
D014151:Anti-Anxiety Agents; D000525:Alprazolam