Abrahams Ronald R, MacKay-Dunn Marion H, Nevmerjitskaia Victoria, MacRae G Scott, Payne Sarah P, Hodgson Zoë G
Department of Family Practice, University of British Columbia, Vancouver BC; Perinatal Addictions Program, BC Women's Hospital and Health Centre, Vancouver BC; Women's Health Research Institute, Vancouver BC.
Women's Health Research Institute, Vancouver BC.
J Obstet Gynaecol Can. 2010 Sep;32(9):866-871. doi: 10.1016/S1701-2163(16)34659-X.
Rooming-in, the practice of caring for mother and newborn together in the same room immediately from birth, is preferred for the general postpartum population but is not yet standard practice of care for newborns of substance-using women. Such newborns are usually separated from their mothers and admitted to a neonatal intensive care unit and treated for substance withdrawal if necessary. We compared clinical and psychosocial outcomes associated with traditional standard care models versus an interdisciplinary rooming-in model of care for substance-exposed newborns.
We conducted a retrospective comparative review of a cohort of substance-exposed newborns. Data were extracted from the British Columbia Perinatal Health Program database to populate the standard care and rooming-in groups. The main study outcomes were neonatal admission to NICU, breastfeeding, presence of neonatal withdrawal, length of stay, and custody status at discharge.
Rooming-in was associated with a significant decrease in admissions to NICU and a shorter NICU length of stay for term infants, increased likelihood of breastfeeding (either exclusively or in combination with formula) during the hospital stay, and increased odds of the baby being discharged home with the mother. There were no significant differences between groups with respect to the presence of neonatal substance withdrawal or breastfeeding status at discharge.
Rooming-in may facilitate a smooth transition to extrauterine life for substance-exposed newborns by decreasing NICU admissions and NICU length of stay for term infants, encouraging breastfeeding, and increasing maternal custody of infants at discharge. This review supports the finding that rooming-in is both safe and beneficial for substance-exposed babies.
母婴同室，即婴儿出生后立即与母亲在同一房间共同护理，这对一般产后人群来说是首选做法，但对于使用药物的女性所生新生儿而言，尚未成为标准护理方式。此类新生儿通常会与母亲分开，入住新生儿重症监护病房，必要时接受药物戒断治疗。我们比较了传统标准护理模式与针对接触药物新生儿的跨学科母婴同室护理模式相关的临床和心理社会结局。
我们对一组接触药物的新生儿进行了回顾性比较研究。数据从不列颠哥伦比亚省围产期健康项目数据库中提取，以纳入标准护理组和母婴同室组。主要研究结局包括新生儿入住新生儿重症监护病房情况、母乳喂养情况、新生儿戒断症状的出现、住院时长以及出院时的监护状态。
母婴同室与足月儿入住新生儿重症监护病房的人数显著减少以及在新生儿重症监护病房的住院时间缩短相关，增加了住院期间纯母乳喂养（或母乳喂养与配方奶混合喂养）的可能性，以及婴儿与母亲一同出院回家的几率。两组在新生儿药物戒断症状的出现或出院时的母乳喂养状态方面没有显著差异。
母婴同室可能通过减少足月儿入住新生儿重症监护病房的人数和在新生儿重症监护病房的住院时间、鼓励母乳喂养以及增加出院时母亲对婴儿的监护，促进接触药物的新生儿顺利过渡到宫外生活。本综述支持母婴同室对接触药物的婴儿既安全又有益这一发现。
