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母亲物质使用与新生儿戒断综合征:一项描述性研究。

Maternal Substance Use and Neonatal Abstinence Syndrome: A Descriptive Study.

作者信息

McQueen Karen A, Murphy-Oikonen Jodie, Desaulniers Lindsay

机构信息

Lakehead University School of Nursing, 955 Oliver Rd, Thunder Bay, ON, P7B 5E1, Canada,

出版信息

Matern Child Health J. 2015 Aug;19(8):1756-65. doi: 10.1007/s10995-015-1689-y.

Abstract

Neonatal Abstinence Syndrome (NAS) is one of the primary negative effects of substance use during pregnancy. The exact statistics regarding NAS and substance use during pregnancy are difficult to determine due to underreporting, especially in the context of pregnancy. Similarly, little is known regarding whether the severity of NAS differs based on substance exposure. The purpose of this study was to evaluate the prevalence of NAS and types of substance use during pregnancy, and determine whether the presentation of NAS symptoms differ based on the type of substance. A retrospective chart review was conducted over a one year period at a tertiary care hospital. One hundred thirty-one mother-infant pairs met the inclusion criteria of documented NAS scores using the Modified Finnegan Scoring Tool and substance use during pregnancy. The results identified a high prevalence of NAS (8.7 %) primarily as a result of exposure to illicit opioids and/or to methadone as the treatment for opioid addiction. In addition, more than half the women on methadone maintenance treatment continued to use additional substances primarily opiates. Infants who were exposed to methadone experienced more severe NAS compared to infants not exposed to methadone including higher peak scores, prolonged NAS treatment, and length of stay. Given the severity of symptoms of the methadone exposed infants and the high rate of opioid use with methadone treatment, evidence-based interventions are required to decrease the negative effects of NAS.

摘要

新生儿戒断综合征(NAS)是孕期药物使用的主要负面影响之一。由于报告不足,尤其是在孕期背景下,关于NAS和孕期药物使用的确切统计数据难以确定。同样,关于NAS的严重程度是否因药物暴露而异,人们知之甚少。本研究的目的是评估NAS的患病率和孕期药物使用类型,并确定NAS症状的表现是否因药物类型而异。在一家三级护理医院进行了为期一年的回顾性病历审查。131对母婴符合使用改良芬尼根评分工具记录NAS评分和孕期药物使用的纳入标准。结果发现NAS的患病率很高(8.7%),主要是由于接触非法阿片类药物和/或作为阿片类药物成瘾治疗的美沙酮。此外,接受美沙酮维持治疗的女性中,超过一半继续使用其他主要为阿片类的药物。与未接触美沙酮的婴儿相比,接触美沙酮的婴儿经历了更严重的NAS,包括更高的峰值评分、更长的NAS治疗时间和住院时间。鉴于接触美沙酮的婴儿症状严重,且美沙酮治疗中阿片类药物使用率高,需要基于证据的干预措施来减少NAS的负面影响。

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