Liu William F, Singh Kultar, Faisal Mohamed, Li Shuang
Division of Neonatology, Golisano Children's Hospital of Southwest Florida, Fort Myers, Florida.
Department of Mathematics, Florida Gulf Coast University, Fort Myers, Florida.
Am J Perinatol. 2015 Sep;32(11):1078-86. doi: 10.1055/s-0035-1549218. Epub 2015 Apr 27.
This article aims to describe neonatal outcomes, clinical correlates, and the rate for neonatal abstinence syndrome (NAS) for women on methadone maintenance therapy.
This study is a retrospective review, which includes 119 mothers and 120 live newborns.
Methadone mothers tends to be white, single, on government insurance, with increased tobacco use (73%) and hepatitis C (11%). Prematurity increased (28%), and the term infant had a higher risk for admission for respiratory symptoms (22, 7%, p < 0.001). Overall, 78% newborns developed NAS, with the onset of symptoms 4.3 ± 2.9 days, and average length of stay of 36.7 ± 26.4 days. There was a decreased overall gestational age for those infants who did not have NAS (36, 38 weeks, p = 0.04). Overall, 56% had possible illicit drug supplementation. Self-reporting had a 59% negative predictive value with a positive drug screen. No difference in maternal methadone dosage and newborns with and without NAS. Increasing gestational age will increase the odds for NAS.
Newborns are at higher risk for prematurity and admission for respiratory symptoms. Utilizing a 7-day observation period, 78% of newborns were diagnosed with NAS with a mean onset of symptoms of 4.3 days. There was no difference in methadone dosage between babies with and without NAS. Increasing gestational age increases the risk for NAS.
本文旨在描述接受美沙酮维持治疗的女性的新生儿结局、临床关联因素以及新生儿戒断综合征（NAS）的发生率。
本研究为回顾性研究，纳入了119名母亲和120名活产新生儿。
服用美沙酮的母亲往往为白人、单身，享受政府保险，吸烟率增加（73%）且丙型肝炎感染率为（11%）。早产率增加（28%），足月儿因呼吸道症状入院的风险更高（22.7%，p<0.001）。总体而言，78%的新生儿出现NAS，症状出现时间为4.3±2.9天，平均住院时间为36.7±26.4天。未患NAS的婴儿总体孕周缩短（36.38周，p=0.04）。总体而言，56%的婴儿可能有非法药物补充。自我报告在药物筛查呈阳性时的阴性预测值为59%。母亲美沙酮剂量在患NAS和未患NAS的新生儿之间无差异。孕周增加会增加患NAS的几率。
新生儿早产和因呼吸道症状入院的风险更高。采用7天观察期，78%的新生儿被诊断为NAS，平均症状出现时间为4.3天。患NAS和未患NAS的婴儿美沙酮剂量无差异。孕周增加会增加患NAS的风险。
