title: [Neonatal abstinence syndrome after maternal use of tramadol].
abstract: BACKGROUND
  Tramadol is an opioid with lipophilic characteristics that freely crosses the placenta. Due to the placental transfer, there is a risk of neonatal withdrawal symptoms. Therefore, chronic use during pregnancy is not advised.
  
  
  METHODS
  A 25-year-old pregnant woman, gravida 3, para 1, used tramadol 100 mg 3 times a day for chronic headache and migraine during this pregnancy. Because of the risk for neonatal abstinence syndrome, delivery took place in the hospital and the neonate had to stay at least 3 days for observation. The newborn developed neonatal withdrawal symptoms 36 hours after delivery. Treatment with phenobarbital was effective; 9 days after delivery the newborn was discharged without further treatment.
  
  
  CONCLUSIONS
  When tramadol is used during pregnancy, there is a serious risk for neonatal abstinence syndrome. Phenobarbital proved to be effective for the treatment of neonatal tramadol withdrawal.
authors: Westfriesgasthuis, Afd. Klinische Farmacie, Hoorn, the Netherlands. djoekedewit@gmail.com
authors: Djoeke
authors: D
authors: de Wit
authors: Irene
authors: I
authors: Koomen-Botman
mesh_terms: D000328:Adult; D000701:Analgesics, Opioid / Q000009:adverse effects* / Q000378:metabolism / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D009357:Neonatal Abstinence Syndrome / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology; D009293:Opioid-Related Disorders / Q000150:complications* / Q000188:drug therapy; D010634:Phenobarbital / Q000627:therapeutic use; D010920:Placenta / Q000378:metabolism; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy; D014147:Tramadol / Q000009:adverse effects* / Q000378:metabolism / Q000627:therapeutic use
chemical_list: D000701:Analgesics, Opioid; D014147:Tramadol; D010634:Phenobarbital