Neurological fragility in the newborn: Influence of medication in labour.

New anaesthetic and analgesic drugs continue to be introduced in labour, with little apparent concern about possible effects on the foetus or neonate beyond the more gross changes reflected by the Apgar score. A review is presented of some drugs currently used and some of the newer methods available for the assessment of the neonate. It is important that attention should be given to the subtler effects of drugs on the nervous system in addition to the gross effects on the respiratory and other systems as judged by the Apgar score. It is also essential to correlate neurobehavioural status of the newborn infant with an accurate assessment of gestational age, in order to produce a scale of reference against which effects of drugs administered in labour can be judged.