Serum concentrations of psychotropic drugs in neonates as a PROgnOstic Factor for admission to the neonatology ward and withdrawal symptoms: PROOF-1.
The aim is to determine whether serum drug concentrations obtained from the neonate's umbilical cord can be used as a prognostic factor for admission to the neonatology ward and the occurrence of withdrawal symptoms. A retrospective observational monocenter cohort study was carried out among pregnant women using psychotropic drugs and their baby. Binary logistic regression was used for the multivariate analysis. Of the 186 neonates included, 22.6% (n=42) were admitted to the neonatology ward, 6.5% (n=12) because of withdrawal. Among women with therapeutic concentrations of psychotropic medication, 22.0% (n=5) of the neonates had withdrawal symptoms. When comparing neonates with therapeutic versus undetectable drug concentrations, an odds ratio of 3.1 (95% confidence interval: 1.1-8.6) was found for admission to the neonatology ward and an odds ratio of 20.5 (95% confidence interval: 2.2-186.1) for the occurrence of withdrawal symptoms. Therapeutic concentrations of psychotropic drugs in neonates' umbilical cord blood correspond with higher odds for admission to the neonatology ward and the occurrence of withdrawal symptoms compared with neonates with undetectable drug concentrations. The measurement of drug concentrations in the neonate may contribute toward the general clinical assessment of the physician to predict the necessity of admission to the neonatology ward and the risk of withdrawal symptoms.
Departments of aHospital Pharmacy bPsychiatry cGynecology dPediatrics eMeander Academy, Meander Medical Center, Amersfoort fDepartment of Gynecology, UMC Utrecht, Utrecht, The Netherlands.
Shirley C A
SC
Sparla
Hans
H
Coppens
Inge M
IM
Evers
Claire A I
CA
Stramrood
Pieternel C M
PC
Pasker-de Jong
Monique M L
MM
van der Westerlaken
Paul H G
PH
Hogeman
Mirte M
MM
Malingré
D000328:Adult; D005260:Female; D005312:Fetal Blood / Q000378:metabolism*; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D009426:Netherlands / Q000453:epidemiology; D016017:Odds Ratio; D011237:Predictive Value of Tests; D011619:Psychotropic Drugs / Q000009:adverse effects / Q000097:blood*; D012189:Retrospective Studies; D013375:Substance Withdrawal Syndrome / Q000175:diagnosis* / Q000453:epidemiology
D011619:Psychotropic Drugs