Neonatal behavior in a group of infants whose mothers received pethidine (Demerol) during labor was assessed at delivery and during the first six weeks of life by means of the Brazelton Neonatal Behavioural Assessment Scale (BNBAS). Higher cord blood levels of pethidine were associated with babies who were more prone to respiratory difficulties, and drowsy and unresponsive immediately after delivery. Infants of mothers who had had a high total dose of pethidine were likely to spend more time in a cot, and less time held by the mother or father, interacting with the mother or being looked at by her. Throughout the six weeks in which the assessments were made, depressed attention and social responsiveness were found in infants with high drug levels. At three and six weeks, the infant whose exposure to pethidine had been high tended to change state more frequently, to cry during the test and to be less capable of quieting himself.
No relation could be established between performance by the baby in the first hour and the measures of pethidine. This suggests that when the infant is aroused to an optimal alert state by the tester, his orientation skills and tone are not impaired by the degree of medication induced in this study. It has been suggested that birth itself may sufficiently stimulate the infant to cope with events in the first few hours, but that in the following period behavioral organization may temporarily disintegrate. The "drugged" infant would take longer to recover from such disorganization.
Overall the authors conclude that greater exposure to pethidine results in neonatal behavior which is significantly depressed in areas of functioning which might affect the ability of the mother to adjust to her baby in the first few weeks of his life.
-EM Belsey, et al, "The influence of maternal analgesia on neonatal behaviour: 1 Pethidine," British Journal of OB and Gyn, April 1981, Vol. 88
Reprinted from Midwifery Today E-News (Vol 1 Issue 20, May 14, 1999)
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