Confirmation of gestational exposure to alprazolam by analysis of biological matrices in a newborn with neonatal sepsis

  title={Confirmation of gestational exposure to alprazolam by analysis of biological matrices in a newborn with neonatal sepsis},
  author={{\'O}scar Garc{\'i}a-Algar and Maria Angeles López-Vilchez and Itziar Mart{\'i}n and Antonio Mǔr and Manuela Pellegrini and Roberta Pacifici and Silvia Rossi and Simona Pichini},
  journal={Clinical Toxicology},
  pages={295 - 298}
Background. Different biological matrices are suitable for drug testing in newborns presenting with an acute withdrawal syndrome. Case report. 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 (α-hydroxyalprazolam) were detected in cord serum, neonatal urine and also in neonatal hair, meconium and… 

Diazepam and its metabolites in the mothers' and newborns' hair as a biomarker of prenatal exposure.

Diazepam and its metabolites determined in hair of newborns may serve as biomarkers of prenatal exposure to these drugs and confirm that these benzodiazepines permeate placental barrier.

Drugs of abuse in maternal hair and paired neonatal meconium: an objective assessment of foetal exposure to gestational consumption.

It seems that discontinuous and/or sporadic consumption during pregnancy could produce a negligible transplacental passage and hence negative results in meconium, and the role of placenta in the metabolism and excretion of drugs of abuse is still to be precisely investigated.

Neonatal hair analysis to reveal gestational exposure to drugs

Collection of neonatal hair at birth is useful for retrospective assessment of exposure to drugs during the third trimester of gestation, through the identification and quantification of specific biomarkers.

Maternal and neonatal hair and breast milk in the assessment of perinatal exposure to drugs of abuse.

The present manuscript reviews the newest analytical methods developed to detect drugs of abuse as well as ethanol biomarkers in maternal and neonatal hair and breast milk.

Neonatal Adaptation Issues After Maternal Exposure to Prescription Drugs: Withdrawal Syndromes and Residual Pharmacological Effects

This narrative review is aimed at the description of drugs and drug classes for which licit maternal use in the predelivery period has been associated with neonatal non-teratogenic disorders, mainly for substances used illicitly for recreational purposes.

Bioanalysis during pregnancy: recent advances and novel sampling strategies.

Methods published for the determination of in utero drug exposure from 2007 to 2014 are reviewed, with special focus on meconium, placenta, umbilical cord and newborn hair.

Maternal methadone dose, placental methadone concentrations, and neonatal outcomes.

Quantitative methadone and EDDP measurement may predict NAS severity and the placenta reflects in utero drug exposure for a shorter time than meconium but may be useful when me Conium is unavailable or if documentation of recent exposure is needed.

Bioanalysis for cocaine, opiates, methadone, and amphetamines exposure detection during pregnancy.

Maternal hair was the most sensitive specimen to detect drug exposure during pregnancy, and tested positive if hair concentrations showed frequent drug use during the whole pregnancy, especially during the third trimester.

The role of alternative specimens in toxicological analysis.

This paper reviews a series of publications on the use of alternative specimens, with special focus on the main analytical and chromatographic problems that these samples present, as well on their advantages and disadvantages over traditional samples in documenting drug exposure.

Maternal Buprenorphine Dose, Placenta Buprenorphine, and Metabolite Concentrations and Neonatal Outcomes

Placenta is a potential alternative matrix for detecting in utero buprenorphine exposure, but at lower concentrations than in meconium, which may be valuable for prediction of neonatal outcomes for clinicians treating newborns of bupenorphine-exposed women.



First-Trimester Exposure to Alprazolam

The cases accumulated in this report represent a sample of insufficient size to confirm or refute previous reports of specific congenital anomalies linked to exposure to benzodiazepines, and may provide some reassurance in counseling women following inadvertent prenatal exposure.

Neonatal abstinence syndrome, pharmacotherapy and developmental outcome.

This study evaluated 85 infants born to drug-dependent women who were maintained on methadone during pregnancy and found that developmental status of infants was well within the normal range of development.

Drug disposition and effects in the fetus.

Fetal drug exposure is affected by large number of maternal, placental and fetal factors, and Alterations in fetal behaviour are elicited by prescription sedatives and anesthetics and illicit drugs, and also by the antihistamine, diphenhydramine, present in various nonprescription medications.

Effects of commonly used benzodiazepines on the fetus, the neonate, and the nursing infant.

Minimizing the risks of benzodiazepine therapy among pregnant or lactating women involves using drugs that have established safety records at the lowest dosage for the shortest possible duration, avoiding use during the first trimester, and avoiding multidrug regimens.

Prenatal exposure to arecoline (areca nut alkaloid) and birth outcomes

The hypothesis that chronic exposure of the fetus to arecoline (the principal alkaloid of the areca nut) is the cause was investigated in a clinical observational study on six newborns from Asian mothers who chewed betel nut during pregnancy.

Neonatal nicotine withdrawal syndrome

Assessing the recent in utero exposure to tobacco smoke in newborns from the Barcelona cohort of the AMICS study (Asthma Multicentre Infants Cohort Study) reported observational symptoms suggesting a possible neonatal nicotine withdrawal syndrome in some of the newbornS from smoking mothers.

Pharmacology of the benzodiazepines; with special emphasis on alprazolam

  • B. Söderpalm
  • Biology, Psychology
    Acta psychiatrica Scandinavica. Supplementum
  • 1987
Different aspects on the structure‐activity relationships, the pharmacokinetic and the pharmacodynamic properties of the benzodiazepines (BDZs) are briefly outlined, followed by a more thorough