Roy J, Toubin R-M, Mazurier E, Chanal C, Misraoui M, Brulet C, Molenat F
Service de pédopsychiatrie, unité petite enfance, clinique Peyre-Plantade, hôpital La-Colombiére, 34090 Montpellier, France.
Arch Pediatr. 2011 Nov;18(11):1130-8. doi: 10.1016/j.arcped.2011.08.014. Epub 2011 Oct 2.
Studies on infant outcomes of opiate-dependent pregnant women find a high rate of premature mother-child separation and to a lesser extent developmental delay. The specific role of in utero heroin exposure in the determination of the developmental outcome seems to be less important than the home environment.
Describe the health and development of 5-year-old children whose drug-addict mothers allowed an early multidisciplinary intervention (medical and psychological) in the maternity hospital and neonatology.
Thirty-seven children (62% of the initial cohort) were seen in consultation with their parents. Growth and development was compared with a control group of 374 children of the same age. Comparisons were made between the children's and parents' state (social, medical, drug addiction, etc.) upon discharge from the maternity hospital and 5 years later. A study was conducted on those lost to follow-up.
The rate of placement in 5 years was very low (13%). Seven children showed a developmental delay, 21 no disorder, and nine some problems. Anxiety (37%) and overweight (48%) were the only disorders differentiating them from the control group. Compliance with the care provided in the maternity hospital was the only item significantly related to the development of the 5-year-old children (P=0.05).
The hypothesis of an attachment disorder in those with the greatest need is raised. The likely relations between the quality of the care in the maternity hospital, mother-child relations, and the attrition of the cohort are also discussed.
Management of the symptoms as well as social and psychological care during pregnancy and neonatal hospitalization for opiate-dependent pregnant women facilitates a long-lasting relation with childhood professionals, avoids court-ordered placements, and reduces the appearance of developmental disorders in these children.
关于阿片类药物依赖孕妇的婴儿结局研究发现，母婴过早分离的发生率很高，发育迟缓的发生率相对较低。子宫内海洛因暴露在决定发育结局方面的具体作用似乎不如家庭环境重要。
描述其吸毒母亲在产科医院和新生儿科接受早期多学科干预（医学和心理）的5岁儿童的健康和发育情况。
对37名儿童（占初始队列的62%）及其父母进行了会诊。将其生长发育情况与374名同龄对照组儿童进行比较。对产科医院出院时及5年后儿童及其父母的状况（社会、医疗、药物成瘾等）进行了比较。对失访者进行了研究。
5年内被安置的比例非常低（13%）。7名儿童发育迟缓，21名无异常，9名有一些问题。焦虑（37%）和超重（48%）是将他们与对照组区分开来的唯一异常情况。在产科医院接受护理的依从性是与5岁儿童发育显著相关的唯一因素（P = 0.05）。
提出了最需要帮助的人群中存在依恋障碍的假设。还讨论了产科医院护理质量、母婴关系和队列损耗之间可能的关系。
对阿片类药物依赖孕妇在孕期和新生儿住院期间进行症状管理以及社会和心理护理，有助于与儿童期专业人员建立长期关系，避免法院下令的安置，并减少这些儿童发育障碍的出现。
