Centre for Addiction Research, Institute of Psychiatry, University of Oslo, Oslo, Norway.
Eur Addict Res. 2009;15(3):128-34. doi: 10.1159/000210042. Epub 2009 Mar 31.
Opioid maintenance treatment (OMT) is widely used to treat pregnant women with a history of opioid dependence. This study investigated whether maternal methadone/buprenorphine dose and nicotine use in pregnancy affects the occurrence and duration of neonatal abstinence syndrome (NAS) in the infant.
Forty-one pregnant women from OMT programmes in Norway who gave birth between January 2005 and January 2007 were enrolled in a national prospective study. Thirty-eight women (81% of the population) were interviewed in the last trimester of pregnancy and 3 months after delivery. Data from the European Addiction Severity Index and a questionnaire measuring enrolled birth information were compared with medical records and urine analyses.
Treatment requiring NAS occurred in 58% of the methadone-exposed and in 67% of the buprenorphine-exposed infants. There was no significant relationship between a maternal dose of methadone or buprenorphine in pregnancy and NAS treatment duration for the infant. The mean number of cigarettes consumed correlated significantly with NAS treatment duration for the methadone group. Birth weight for the methadone group was approximately 200 g above international findings despite high doses during pregnancy.
Maternal methadone/buprenorphine dose predicted neither the occurrence nor the need for NAS treatment for the infant.
阿片类药物维持治疗（OMT）被广泛用于治疗有阿片类药物依赖史的孕妇。本研究旨在调查孕妇在孕期使用美沙酮/丁丙诺啡的剂量和尼古丁使用是否会影响婴儿出现新生儿戒断综合征（NAS）的概率和持续时间。
41 名来自挪威 OMT 项目的孕妇于 2005 年 1 月至 2007 年 1 月期间分娩，参与了一项全国性前瞻性研究。38 名女性（占总人数的 81%）在妊娠晚期和分娩后 3 个月接受了访谈。欧洲成瘾严重程度指数的数据和一份测量入组出生信息的问卷与医疗记录和尿液分析进行了比较。
接受 NAS 治疗的婴儿中，美沙酮暴露组占 58%，丁丙诺啡暴露组占 67%。孕妇在孕期使用美沙酮或丁丙诺啡的剂量与婴儿接受 NAS 治疗的持续时间之间无显著关系。在美沙酮组中，母亲吸烟的数量与 NAS 治疗持续时间呈显著相关。尽管孕期使用了高剂量的美沙酮，但该组婴儿的出生体重比国际研究发现的平均水平高出约 200 克。
母亲使用美沙酮/丁丙诺啡的剂量既不能预测婴儿出现 NAS 的概率，也不能预测婴儿需要接受 NAS 治疗的概率。
