[丁丙诺啡与妊娠。24例病例分析]
[Buprenorphine and pregnancy. Analysis of 24 cases].
作者信息
Jernite M, Viville B, Escande B, Brettes J P, Messer J
机构信息
Service de pédiatrie II, hôpital Central, Strasbourg, France.
出版信息
Arch Pediatr. 1999 Nov;6(11):1179-85. doi: 10.1016/S0929-693X(00)86300-9.
BACKGROUND
Maintenance therapy of drug-addict mothers with medical and psychosocial support may reduce complications (prematurity, growth retardation, fetal distress and fetal death). Methadone has been widely used during pregnancy with beneficial effects. Buprenorphine (BUP) is used more and more and shows the same beneficial effects.
PATIENTS AND METHOD
Twenty-four pregnant women received BUP and their infants were enrolled in the study. Thirteen retrospective (GI) and 11 prospective (GII) cases were studied. In the GII, the women were treated and followed up in an interdisciplinary manner.
RESULTS
Complications in GII were less frequent than in GI: 9 vs 30% of prematurity, 9 vs 46% of fetal growth retardation and 0 vs 23% of acute fetal distress. However, the frequency of withdrawal syndrome was the same in both groups, 63 vs 69%, though improvements came more rapidly in GII.
CONCLUSION
This study shows that the use of BUP during pregnancy, combined with medical and psychosocial support, may reduce addiction complications. This support has to be maintained after the birth.
背景
为吸毒成瘾的母亲提供药物及心理社会支持的维持治疗可能会减少并发症（早产、生长发育迟缓、胎儿窘迫和胎儿死亡）。美沙酮在孕期已被广泛使用且具有有益效果。丁丙诺啡（BUP）的使用越来越多，且显示出相同的有益效果。
患者与方法
24名孕妇接受了丁丙诺啡治疗，其婴儿被纳入研究。研究了13例回顾性病例（GI组）和11例前瞻性病例（GII组）。在GII组中，对这些女性进行了多学科治疗及随访。
结果
GII组的并发症发生率低于GI组：早产发生率分别为9%和30%，胎儿生长发育迟缓发生率分别为9%和46%，急性胎儿窘迫发生率分别为0和23%。然而，两组戒断综合征的发生率相同，分别为63%和69%，尽管GII组症状改善更快。
结论
本研究表明，孕期使用丁丙诺啡并结合医疗和心理社会支持，可能会减少成瘾并发症。出生后仍需维持这种支持。
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