Crocetti Michael T, Amin Diane D, Jansson Lauren M
Department of Pediatrics, Johns Hopkins Bayview Medical Center, Baltimore, Maryland, USA.
Clin Pediatr (Phila). 2007 Sep;46(7):632-5. doi: 10.1177/0009922807300699. Epub 2007 May 23.
During 2003 and 2004 an estimated 2000 pregnant women and 31 000 nonpregnant women aged 15 to 44 reported using heroin. The majority of those newborns exposed in utero to opioids will develop symptoms of neonatal abstinence syndrome (NAS). Standardized guidelines for the evaluation and management of opiate-exposed newborns are lacking. The objective of this study was to document variations in the evaluation and management of opiate-exposed newborns among Maryland hospitals using a 13-item phone survey. Twenty-seven (82%) of the hospitals completed the survey. Staff at every hospital reported that they delivered opiate-exposed infants, however only 52% reported using a standardized evaluation and treatment protocol for this population consisting of guidelines for maternal toxicology screening, length-of-stay criteria and a monitoring tool for drug-exposed infants, infant supportive care techniques, and pharmacologic treatment guidelines. Significant variability exists in the evaluation and management of opiate-exposed newborns in Maryland. Validated, evidence-based guidelines are needed to standardize the care of these vulnerable newborns across all hospital settings.
在2003年至2004年期间，估计有2000名孕妇和31000名年龄在15至44岁的非孕妇报告使用过海洛因。大多数在子宫内接触阿片类药物的新生儿会出现新生儿戒断综合征（NAS）的症状。目前缺乏针对接触阿片类药物新生儿的评估和管理的标准化指南。本研究的目的是通过一项包含13个项目的电话调查，记录马里兰州各医院在接触阿片类药物新生儿评估和管理方面的差异。27家（82%）医院完成了调查。每家医院的工作人员都报告称他们接生过接触阿片类药物的婴儿，然而只有52%的医院报告针对这一人群使用了标准化的评估和治疗方案，该方案包括孕产妇毒理学筛查指南、住院时间标准、针对药物接触婴儿的监测工具、婴儿支持性护理技术以及药物治疗指南。马里兰州在接触阿片类药物新生儿的评估和管理方面存在显著差异。需要经过验证的、基于证据的指南，以规范所有医院环境中这些脆弱新生儿的护理。
