Kraigher D, Schindler S, Ortner R, Fischer G
Drogenambulanz, Klinische Abteilung für Allgemeine Psychiatrie, Universitätsklinik für Psychiatrie, AKH Wien.
Gesundheitswesen. 2001 Aug;63 Suppl 2:S101-5. doi: 10.1055/s-2001-16419.
Substance dependency in pregnancy leads to severe health risks for the expecting mother and for the foetus and the new-born. The problem of substance dependent pregnant women lies not only in the use of illegal substances but also to a high degree in the use of legal substances such as alcohol and nicotine. In contrast to most other substances of abuse, opioids do not show cytotoxic or teratogenic characteristics. The primary goal should be the stabilisation of the patient and a reduction of additional illicit consumption. The ideal goal of abstinence is difficult to reach and often puts the women under enhanced risks. Detoxification after week 32 should not be undertaken in order to avoid preterm delivery. It should be standardised that a multiprofessional and interdisciplinary therapeutical care leads to a stabilisation in opioid dependent pregnant addicts and therefore improves the outcome for neonates. Special awareness needs to be addressed towards the diversification of opioid maintenance therapy. Based on the positive results in opioid maintenance therapy in pregnant opioid dependent women, it will be required to establish standards. Furthermore there is a need to establish consistent guidelines for the treatment of the neonatal abstinence syndrome.
孕期药物依赖会给孕妇、胎儿及新生儿带来严重的健康风险。药物依赖孕妇的问题不仅在于使用非法药物，很大程度上还在于使用酒精和尼古丁等合法药物。与大多数其他滥用药物不同，阿片类药物不具有细胞毒性或致畸特性。首要目标应是使患者病情稳定，并减少额外的非法药物使用。完全戒除这一理想目标很难实现，而且往往会使女性面临更大风险。为避免早产，不应在怀孕32周后进行戒毒。应规范多专业、跨学科的治疗护理，以使阿片类药物依赖的怀孕成瘾者病情稳定，从而改善新生儿的结局。需要特别关注阿片类药物维持治疗的多样化。鉴于阿片类药物维持治疗对怀孕的阿片类药物依赖女性取得了积极效果，将需要制定相关标准。此外，还需要为新生儿戒断综合征的治疗制定一致的指导方针。
