预测美沙酮暴露新生儿的新生儿戒断综合征治疗时长
Predicting length of treatment for neonatal abstinence syndrome in methadone-exposed neonates.
作者信息
Seligman Neil S, Salva Nicole, Hayes Edward J, Dysart Kevin C, Pequignot Edward C, Baxter Jason K
机构信息
Department of Obstetrics and Gynecology, Thomas Jefferson University, Philadelphia, PA 19107, USA.
出版信息
Am J Obstet Gynecol. 2008 Oct;199(4):396.e1-7. doi: 10.1016/j.ajog.2008.06.088.
OBJECTIVE
The objective of the study was to identify maternal variables predicting length of treatment for neonatal abstinence syndrome (NAS).
STUDY DESIGN
This was a retrospective cohort study of infants treated for NAS during 2000-2006 whose mothers were on methadone maintenance at delivery. Mixed-effects linear regression was used to examine the interaction of maternal and neonatal variables with length of treatment.
RESULTS
Of 204 neonates born to methadone exposed mothers, the average dose at delivery was 127 mg daily (25-340 mg) with median length of treatment 32 days (1-122 days). Trimester of initial exposure (P = .33), methadone dose at delivery (P = .198), body mass index (P = .31), antidepressant use (P = .40), cigarette use (P = .76), race (P = .78), and maternal age (P = .84) did not predict length of treatment. In the multivariate analysis, gestational age at delivery and benzodiazepine use were significant predictors of length of treatment.
CONCLUSION
Later gestational age and concomitant benzodiazepine use were associated with longer treatment.
目的
本研究的目的是确定预测新生儿戒断综合征（NAS）治疗时长的母体变量。
研究设计
这是一项对2000年至2006年期间接受NAS治疗的婴儿进行的回顾性队列研究，这些婴儿的母亲在分娩时接受美沙酮维持治疗。采用混合效应线性回归来检验母体和新生儿变量与治疗时长之间的相互作用。
结果
在204名母亲使用过美沙酮的新生儿中，分娩时的平均剂量为每日127毫克（25 - 340毫克），治疗时长中位数为32天（1 - 122天）。初次接触的孕期（P = 0.33）、分娩时的美沙酮剂量（P = 0.198）、体重指数（P = 0.31）、抗抑郁药使用情况（P = 0.40）、吸烟情况（P = 0.76）、种族（P = 0.78）和母亲年龄（P = 0.84）均不能预测治疗时长。在多变量分析中，分娩时的孕周和苯二氮䓬类药物的使用是治疗时长的显著预测因素。
结论
孕周较大和同时使用苯二氮䓬类药物与较长的治疗时间相关。
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