the Maine Dartmouth Family Medicine Residency, Augusta, ME 04330.
J Am Board Fam Med. 2011 Mar-Apr;24(2):194-201. doi: 10.3122/jabfm.2011.02.100155.
Within a family medicine residency, an outpatient buprenorphine treatment program was provided for pregnant women who were dependent on opioids. The purpose of this study was to investigate the outcomes of infants who were exposed to a range of doses of buprenorphine in utero and to determine how closely observed maternal/fetal outcomes (eg, method of delivery and infants requiring treatment for neonatal abstinence syndrome [NAS]) match those previously reported in the literature.
This study consists of a retrospective case series of 23 infants born to 22 pregnant women who were dependent on opioids and who were treated with buprenorphine during a 31-month period.
Thirty-five percent of infants (8 of 23) required treatment for NAS. There was no significant relationship between maternal dose of buprenorphine and birth weight, NAS severity (ie, peak NAS score), or time to first peak NAS score. Infants born to tobacco users had a significantly lower birth weight (P = .0136) than infants born to nonusers. Seventy percent of infants (16 of 23) were breastfeeding at the time of discharge from the hospital.
The observations made in this case series are consistent with data previously reported in the literature. Infants in this study were more likely to be breastfed than those previously described by others, but further analysis is necessary to determine whether this finding is significant.
在家庭医学住院医师培训中，为依赖阿片类药物的孕妇提供门诊丁丙诺啡治疗方案。本研究旨在调查胎儿暴露于丁丙诺啡不同剂量的婴儿的结局，并确定密切观察的母婴/胎儿结局（例如，分娩方式和需要治疗新生儿戒断综合征[NAS]的婴儿）与文献中先前报道的结局有多吻合。
本研究包括 22 名依赖阿片类药物的孕妇所生的 23 名婴儿的回顾性病例系列研究，这些孕妇在 31 个月的时间里接受丁丙诺啡治疗。
35%的婴儿（23 名中的 8 名）需要接受 NAS 治疗。母亲丁丙诺啡剂量与出生体重、NAS 严重程度（即，NAS 评分峰值）或首次 NAS 评分峰值的时间无显著关系。与非吸烟者相比，吸烟者所生婴儿的出生体重显著较低（P =.0136）。70%的婴儿（23 名中的 16 名）在出院时正在母乳喂养。
本病例系列中的观察结果与文献中先前报道的数据一致。本研究中的婴儿更有可能进行母乳喂养，这比其他人之前描述的情况更为常见，但需要进一步分析以确定这一发现是否具有统计学意义。
