The following statement is made because of the concern of the Committee on Drugs of the American Academy of Pediatrics and the Committee on Obstetrics: Maternal and Fetal Medicine of the American College of Obstetricians and Gynecologists about known and unknown effects on the fetus and the newborn of drugs given during labor and delivery.
In the past, the effects on infant welfare of various intrapartum events, obstetrical procedures, and pharmacological agents administered to women during labor and delivery were measured by mortality, Apgar scores, acid-base studies, and specific types of neonatal morbidity.1 With advancing medical knowledge and improved technology for monitoring the well-being of the infant in utero, safer methods for delivery became available. Along with this advancement in technical skills came a decrease in the use of centrally depressant analgesic, sedative, and anesthetic drugs and an increased use of local or regional anesthesia so that the mother could remain alert and aware during labor and delivery.
Recent advances in laboratory methods for drug analysis2 have given physicians a greater insight into maternal-fetal pharmacokinetics, although there is still a great void in medical knowledge related to specific drug transfer, routes of metabolism, and effects of these drugs and drug metabolites on the infant. Prenatally the mother plays the major role in metabolizing and excreting a drug, but once delivery is accomplished the infant is required to perform these functions.
Adverse effects on later intelligence, neuromuscular physiology, learning ability, and behavior have not been reported beyond infancy in children whose mothers received acceptable doses of analgesic, sedative, or anesthetic drugs during labor and delivery.
- Copyright © 1978 by the American Academy of Pediatrics