Neonatal effects of the administration of meperidine and promethazine to the mother in labor. Double blind study

The authors have verified the possible neonatal effects of the administration of meperidine and promethazine in labor, principally in connection with the neurobehavior of newborn babies in the first hours of life. For this verification we have employed the technique proposed by Brazelton, using the tests considered as the most meaningful by the international literature. We have also examined a homogeneous control group of babies for possible changes. The tests were double blind and always done by the same tester. The APGAR score and the early neonatal morbidity, evaluated in days of stay in hospital, did not show any significant statistical difference between the two groups. Also some neurobehavioral tests appeared more frequently altered in statistically significant terms according to the scale proposed by Brazelton. The tests which showed these changes (in the sense of a deviation from the best performance) were those concerning the hand-to-mouth activity (p<0.001), the plantar reflex (p<0.001) and the general body tone evaluated with different parameters (ventral suspension: p<0.01; passive movements: p<0.001; traction: p<0.001). The other tests, which showed instead slight variations, remained in the confidence limits. It was not possible to notice any interaction between the alteration of the tests and the time between the administration and delivery or the moment of the neurologic test: The presence of slightly insufficient tests does not seem to be connected with the time of intrauterine permanence.