Department of Neonatal Medicine, Division of Women and Child Health, ABM University Health Board, Singleton Hospital, Sketty Lane, Swansea SA2 8QA, UK.
Eur J Pediatr. 2011 Feb;170(2):199-205. doi: 10.1007/s00431-010-1284-6. Epub 2010 Sep 9.
The aim of the study was to determine the contemporary socio-clinical profile and perinatal outcome of illicit substance use in pregnancy in a large UK city and compare with published literature. Cases were identified retrospectively from the 'cause for concern' referrals over 5 years (2003-2007). Data was collected on mother-infant pair from medical notes and laboratory records. Chi-square and Mann-Whitney U tests were used where appropriate for statistical analysis. One hundred sixty-eight women were identified as using illicit substance in pregnancy. Smoking (97.4%), unemployment (85.4%) and single status (42.3%) were frequent. Besides controlled use of methadone, heroin, cannabis and benzodiazepines were the most commonly used drugs. Hepatitis C prevalence was high (29.9%) despite low antenatal screening rates (57.7%). Neonatal morbidity was related to prematurity (22.9%), small for dates (28.6%) and neonatal abstinence syndrome (NAS; 58.9%). By day 5 of life, 95.1% of the babies developing NAS and 96.1% of those requiring pharmacological treatment were symptomatic. Of the infants developing NAS, 31.7% required pharmacological treatment. A total of 82.5% babies went home with their mother, and 21.2% were placed on the Child Protection Register. Only 14.3% were breast feeding at discharge. Illicit substance use in pregnancy continues to be associated with significant maternal and neonatal morbidity, and the socio-clinical profile in this decade appears unchanged in the UK. Hepatitis C prevalence is high, and detection should be improved through targeted antenatal screening. Where facility in the community is unavailable, 5 days of hospital stay is sufficient to safely identify babies at risk of developing NAS. Most babies were discharged home with their mother.
本研究旨在确定在英国某大城市中，大量孕妇使用非法药物的当代社会临床概况和围产期结局，并与已发表的文献进行比较。通过回顾性分析，在 5 年内（2003-2007 年），从“值得关注”的转介中确定了病例。从医疗记录和实验室记录中收集母婴对的数据。适当情况下使用卡方检验和曼-惠特尼 U 检验进行统计学分析。确定了 168 名孕妇在怀孕期间使用非法药物。吸烟（97.4%）、失业（85.4%）和单身状态（42.3%）较为常见。除了规范使用美沙酮外，海洛因、大麻和苯二氮䓬类药物是最常使用的药物。尽管产前筛查率（57.7%）较低，但丙型肝炎的患病率仍较高（29.9%）。新生儿发病率与早产（22.9%）、小于胎龄儿（28.6%）和新生儿戒断综合征（NAS；58.9%）有关。在生命的第 5 天，95.1%出现 NAS 的婴儿和 96.1%需要药物治疗的婴儿都出现了症状。在出现 NAS 的婴儿中，31.7%需要药物治疗。共有 82.5%的婴儿与母亲一起回家，21.2%的婴儿被列入儿童保护登记册。出院时仅有 14.3%的婴儿进行母乳喂养。在英国，孕妇使用非法药物仍然与显著的母婴发病率有关，本十年的社会临床概况似乎没有改变。丙型肝炎的患病率较高，应通过有针对性的产前筛查来提高检测率。如果社区设施不可用，5 天的住院时间足以安全地识别有发生 NAS 风险的婴儿。大多数婴儿与母亲一起出院。
