Abstract
ABSTRACT: The aim of this study was to reappraise the effects of maternal meperidine administration on breathing pattern during the first hours of life taking into account the state of alertness. Because breathing instability is more pronounced during active sleep, we hypothesized that meperidine administration might create a greater risk for respiratory instability during active sleep, the prominent sleep state in new borns. We studied eight full-term, healthy new borns whose mothers had received a continuous i.v. infusion of meperidine (81 ± 9 mg) that was terminated 5.5 ± 2.1 h before delivery. These infants were compared with a control group of eight full-term newbons whose mothers did not receive any opioids. In both groups, all babies were delivered vaginally after a normal labor and had Apgar scores of 9 or 10 at 1 and 5 min. Neonatal gastric secretion and maternal venous and umbilical venous blood were sampled at delivery for determination of meperidine concentration. From 60 to 300 min after delivery, behavioral sleep states and thoracic and abdominal movement as well as transcutaneous arterial oxygen saturation (SaO2) were monitored continuously. The number of apneic spells lasting more than 3 s during 100 min of recording and the percentage of time with SaO2 below 90% in each sleep state were recorded. During quiet sleep, all respiratory variables were similar in both groups. During active sleep, there were significantly more apneic episodes (37.1 ± 25.1 versus 11.2 ± 13.9) and a higher percentage of time with Sao2 < 90% (14.3 ± 16.7% versus 13 ± 1.5%) in the meperidine group than in the control group (p < 0.01). In addition, the percentage of time with Sao2, < 90% was significantly correlated with maternal meperidine dose (p < 0.02), drug-delivery interval (p < 0.01), and gastric concentration of meperidine (p < 0.01). These data show that maternal administration of meperidine induces respiratory abnormalities in healthy, full-term newborns that occur only during active sleep. This result indicates that the state of alertness has to be characterized during the monitoring of long-term neonatal respiratory effects of any narcotic agent. In addition, we speculate that maternal meperidine administration may provoke more severe respiratory disturbances in at-risk neonates and that respiratory monitoring during the first hours of life may be useful in these newborns.
Similar content being viewed by others
Article PDF
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Hamza, J., Benlabed, M., Orhant, E. et al. Neonatal Pattern of Breathing during Active and Quiet Sleep after Maternal Administration of Meperidine. Pediatr Res 32, 412–416 (1992). https://doi.org/10.1203/00006450-199210000-00009
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1203/00006450-199210000-00009
This article is cited by
-
The effects of epidural/spinal opioids in labour analgesia on neonatal outcomes: a meta-analysis of randomized controlled trials
Canadian Journal of Anesthesia/Journal canadien d'anesthésie (2014)