O'Donnell Melissa, Nassar Natasha, Leonard Helen, Hagan Ronnie, Mathews Richard, Patterson Yvonne, Stanley Fiona
Telethon Institute for Child Health Research, 100 Roberts Rd, Subiaco, WA, 6008, Australia.
Pediatrics. 2009 Apr;123(4):e614-21. doi: 10.1542/peds.2008-2888.
Illicit drug use during pregnancy is an important public health issue, with adverse effects on the newborn and implications for subsequent parenting. The aim of this study was to measure the birth prevalence of neonatal withdrawal syndrome over time, associated maternal characteristics and child protection involvement.
This is a retrospective cohort study that used linked health and child protection databases for all live births in Western Australia from 1980 to 2005. Maternal characteristics and mental health-and assault-related medical history were assessed by using logistic regression models.
The birth prevalence of neonatal withdrawal syndrome increased from 0.97 to a high of 42.2 per 10 000 live births, plateauing after 2002. Mothers with a previous mental health admission, low skill level, Aboriginal status or who smoked during pregnancy were significantly more likely to have an infant with neonatal withdrawal syndrome. These infants were at greater risk for having a substantiated child maltreatment allegation and entering foster care. Increased risk for maltreatment was associated with mothers who were aged <30 years, were from socially disadvantaged backgrounds, Aboriginal status, and had a mental health-or assault-related admission.
There has been a marked increase in neonatal withdrawal syndrome in the past 25 years. Specific maternal characteristics identified should facilitate planning for early identification and intervention for these women. Findings demonstrate an important pathway into child maltreatment and highlight the need for well-supported programs for women who use illicit drugs during pregnancy as well as the need for sustained long-term support after birth.
孕期使用违禁药物是一个重要的公共卫生问题，会对新生儿产生不良影响，并对后续养育子女产生影响。本研究的目的是测量新生儿戒断综合征的出生患病率随时间的变化、相关的母亲特征以及儿童保护方面的介入情况。
这是一项回顾性队列研究，使用了西澳大利亚州1980年至2005年所有活产的健康与儿童保护数据库。通过逻辑回归模型评估母亲特征以及与心理健康和攻击相关的病史。
新生儿戒断综合征的出生患病率从每10000例活产0.97例增至最高42.2例，在2002年后趋于平稳。曾有心理健康住院史、技能水平低、原住民身份或孕期吸烟的母亲，其婴儿患新生儿戒断综合征的可能性显著更高。这些婴儿遭受儿童虐待指控并进入寄养照料的风险更大。虐待风险增加与年龄小于30岁、来自社会弱势背景、原住民身份以及有心理健康或攻击相关住院史的母亲有关。
在过去25年里，新生儿戒断综合征显著增加。已确定的特定母亲特征应有助于为这些女性制定早期识别和干预计划。研究结果表明了一条导致儿童虐待的重要途径，并凸显了为孕期使用违禁药物的女性提供充分支持项目的必要性，以及产后持续长期支持的必要性。
