Neonatal Withdrawal Syndrome: A Diagnosis to Keep in Mind

Authors: Vala BS*, Silva CI, Joana A and Castelo R

DOI: 10.23880/pnboa-16000185

Volume 8, Issue 2

Abstract

During pregnancy, women are put through many challenges, sometimes facilitating the appearance of depression and anxiety symptoms, leading to the use of psychotropic drugs like benzodiazepines. We present the case of a male new born who presented breathing distress signs during the first hour of life, needing supplemental oxygen. His mother was diagnosed with depressive syndrome and anxiety and was medicated with escitalopram until six months of pregnancy and diazepam as needed until the end of gestation. He was admitted to the Neonatal Intensive Care Unit. In the first 12 hours of admission, he started with irritability, difficulty calming, and exaggerated Moro reflex. Blood tests, lumbar puncture, and cultures were performed, and antibiotics were started. During the first five days of admission, while on antibiotics, he also presented poor sucking reflexes, altered stools, hyper alert look, hyperreflexia, and jitteriness episodes, with low blood inflammatory markers. Withdrawal syndrome was considered after blood and cerebrospinal fluid cultures were negative, and no improvement of the neurological status with antibiotics. He was monitored with Finnegan’s score and improved with containment and comfort measures. This case pretends to emphasize the importance of adequate psychiatric follow-up during pregnancy and of awareness among neonatologists and pediatricians regarding the medicines that can be related to withdrawal syndrome.

Keywords: Benzodiazepine Neonatal Withdrawal Syndrome Neonatal Respiratory Distress Syndrome Neonatology

View PDF