title: Confirmation of gestational exposure to alprazolam by analysis of biological matrices in a newborn with neonatal sepsis.
abstract: 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.
authors: Servicio de Pediatría, Hospital Universitari del Mar, Barcelona, Spain.
authors: Oscar
authors: O
authors: García-Algar
authors: M Angeles
authors: MA
authors: López-Vílchez
authors: Itziar
authors: I
authors: Martín
authors: Antonio
authors: A
authors: Mur
authors: Manuela
authors: M
authors: Pellegrini
authors: Roberta
authors: R
authors: Pacifici
authors: Silvia
authors: S
authors: Rossi
authors: Simona
authors: S
authors: Pichini
mesh_terms: 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
chemical_list: D014151:Anti-Anxiety Agents; D000525:Alprazolam