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澳大利亚使用丁丙诺啡的母亲及其新生儿的围产期结局。

Perinatal outcomes of Australian buprenorphine-exposed mothers and their newborn infants.

作者信息

Patel Pankaj, Abdel-Latif Mohamed E, Hazelton Briony, Wodak Alex, Chen Julia, Emsley Fiona, Feller John M, Lui Kei, Oei Ju Lee

机构信息

The Department of Newborn Care, Royal Hospital for Women, Sydney, New South Wales, Australia.

出版信息

J Paediatr Child Health. 2013 Sep;49(9):746-53. doi: 10.1111/jpc.12264. Epub 2013 Jun 9.

Abstract

AIM

To determine the short-term outcomes of Australian buprenorphine-exposed mother/infant dyads.

METHODS

Retrospective record review of drug-exposed mothers and infants in Australia. Groups were based on drug exposure: buprenorphine (55, 3.8%), non-buprenorphine opiates (O, 686, 48.6%) and non-opiates (NO, 671, 47.5%).

RESULTS

More than 30% of buprenorphine mothers continued to use heroin (21, 38%) and benzodiazepines (16, 29%). They were more likely to have child at risk concerns (29, 52.7%, P = 0.019) and have previous children placed in out-of-home care (9, 16.3%, P = 049). Buprenorphine babies were less likely to be preterm (16% vs. 25% (O), P = 0.001 and 23% (NO), P = 0.004) and had higher birthweights (median: 3165 g vs. 2842.5 g (O), P < 0.001 and 2900 g (NO), P = 0.004). Buprenorphine and non-buprenorphine opioid babies had similar maximum Finnegan scores (median 10 vs. 11(O), P = 0.144). The number of babies needing abstinence treatment (45% vs. 51% (O), P = 0.411) and length of hospital stay (median days 9 vs. 11(O), P = 0.067) were similar, but buprenorphine infants required lower maximum morphine doses (mg/kg/day) (median 0.4 mg vs. 0.5 mg (O), P = 0.009).

CONCLUSIONS

Short-term medical outcomes of infants of buprenorphine-using mothers are similar to those of non-buprenorphine opiate-using mothers, but interpretation of these results is confounded by the high rates of polydrug exposure in the buprenorphine group. This and other social concerns noted in buprenorphine mothers and infants warrant further study.

摘要

目的

确定澳大利亚使用丁丙诺啡的母婴二元组的短期结局。

方法

对澳大利亚药物暴露的母亲和婴儿进行回顾性记录审查。分组基于药物暴露情况:丁丙诺啡组(55例,3.8%)、非丁丙诺啡阿片类药物组(O组,686例,48.6%)和非阿片类药物组(NO组,671例,47.5%)。

结果

超过30%使用丁丙诺啡的母亲继续使用海洛因(21例,38%)和苯二氮䓬类药物(16例,29%)。她们更有可能担心孩子面临风险(29例,52.7%,P = 0.019),并且之前有孩子被安置在家庭外照料机构(9例,16.3%,P = 0.049)。使用丁丙诺啡的婴儿早产的可能性较小(16% 对比25%(O组),P = 0.001;对比23%(NO组),P = 0.004),并且出生体重较高(中位数:3165克对比2842.5克(O组),P < 0.001;对比2900克(NO组),P = 0.004)。使用丁丙诺啡和非丁丙诺啡阿片类药物的婴儿的最大芬尼根评分相似(中位数10对比11(O组),P = 0.144)。需要戒断治疗的婴儿数量(45%对比51%(O组),P = 0.411)和住院时间(中位数9天对比11天(O组),P = 0.067)相似,但使用丁丙诺啡的婴儿所需的最大吗啡剂量(毫克/千克/天)较低(中位数0.4毫克对比0.5毫克(O组),P = 0.009)。

结论

使用丁丙诺啡的母亲所生婴儿的短期医学结局与使用非丁丙诺啡阿片类药物的母亲所生婴儿相似,但由于丁丙诺啡组中多药暴露率较高,这些结果的解释受到混淆。丁丙诺啡母亲和婴儿中存在的这一情况及其他社会问题值得进一步研究。

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