日本新生児成育医学会雑誌　第33巻　第3号　91 ～ 97頁（2021年）

日本新生児成育医学会雑誌　33(3)：567-573；2021　

受付日：2020．12．07

受理日：2021．03．23

妊婦が内服しているどの種類の向精神薬と出生した児の新生児薬物離脱スコアが関連しているのか

Which Maternal Psychotropic Agents Affect the Neonatal Abstinence Score in Neonates Born to Mothers Who Use Psychotropic Medicine?

＊ 1 兵庫医科大学　小児科学，＊ 2 公立豊岡病院　小児科・新生児科，＊ 3 兵庫医科大学　精神科神経科学，＊ 4 兵庫医科大学　産科婦人科学

＊1 Department of Pediatrics, Hyogo College of Medicine，＊ 2 Department of Pediatrics and Neonatology, Toyooka Hospital，＊ 3 Department of Neuropsychiatry, Hyogo College of Medicine，＊ 4 Department of Obstetrics and Gynecology, Hyogo College of Medicine

中山栗太＊ 1 ＊ 2・宇都宮　剛＊ 1・増田祥行＊ 1・中田あゆみ＊ 1・三崎真生子＊ 1・香田　翼＊ 1・柴田暁男＊ 1・清野仁美＊ 3・奥田真珠美＊ 1・松永寿人＊ 3・柴原浩章＊ 4・竹島泰弘＊ 1

Kurita NAKAYAMA ＊ 1 ＊ 2，Takeshi UTSUNOMIYA ＊ 1，Yoshihisa MASUDA ＊ 1，Ayumi NAKATA ＊ 1， Maiko MISAKI ＊ 1，Tsubasa KOUDA ＊ 1，Akio SHIBATA ＊ 1，Hitomi SEINO ＊ 3，Masumi OKUDA ＊ 1， Hisato MATSUNAGA ＊ 3，Hiroaki SHIBAHARA ＊ 4，Yasuhiro TAKESHIMA ＊ 1

Key Words：neonatal abstinence syndrome，abstinence score，sleep medications，antidepressant，antipsychotic drugs

母体が内服する向精神薬により新生児薬物離脱症候群がおこりうる。2016 年から2019 年に当院で母体が向精神薬を1 剤以上内服していた症例を対象に，児の性別，出生体重，在胎週数，向精神薬の種類および数と新生児薬物離脱スコア（以下離脱スコア）の関連について検討した。また従属変数を離脱スコア，説明変数を性別，出生体重，抗うつ薬，睡眠薬，抗精神病薬のそれぞれの数として線形回帰分析を施行した。対象は82 例で，内服薬は抗精神病薬が50 例，睡眠薬が39 例，抗うつ薬が38 例，抗不安薬が34 例であった。離脱スコアの中央値は1 点で最低は 0，最大は9 点であった。性別による離脱スコアの有意な差は認めず，離脱スコアと母体内服薬剤数の有意な相関は認めなかった。離脱スコアは睡眠薬の数と有意な正の相関を認めた。複数の睡眠薬を内服している母から出生した児では特に注意深い観察を要することが示された。

Introduction
Neonatal abstinence syndrome may occur in neonates born to mothers who use psychotropic medicine. Our purpose was to determine which maternal psychotropic medications are associated with neonatal abstinence scores.
Methods
We performed a retrospective study on neonates born to mothers who were undergoing treatment with at least one psychotropic medicine and were admitted to Hyogo College of Medicine Hospital from 2016 to 2019. First, we investigated the association between the neonatal abstinence score and variables including sex, birth weight, gestational week, and the number of medications. Next, we performed linear regression analysis using the neonatal abstinence score as the outcome and the number of sleep medications, antipsychotics, antidepressants, offspring birth weight, and sex as independent variables.
Results
The subjects were 82 neonates. The results showed that the mothers used antipsychotics（ n＝50） most frequently, followed by sleep agents （n＝39）, antidepressants （n＝38）, and anxiolytics （n＝34）. The median value of neonatal abstinence score was 1. The maximum and minimum value of neonatal abstinence score was 9 and 0, respectively. There was no difference between males and females in the neonatal abstinence scores, and there was no correlation between the neonatal abstinence score and gestational week, birth weight, or the number of maternal psychotropic medicines used. Our findings revealed that neonatal abstinence score was significantly associated with the number of sleep agents that the mother used（ p＝0.01）.
Conclusion
Healthcare providers should carefully observe neonates born to mothers using sleep medications.