Short Vanessa L, Gannon Meghan, Abatemarco Diane J
1 Department of Obstetrics and Gynecology, Division of Maternal Addiction Treatment, Education and Research, Thomas Jefferson University , Philadelphia, Pennsylvania.
Breastfeed Med. 2016 Sep;11:343-9. doi: 10.1089/bfm.2016.0084. Epub 2016 Aug 16.
The incidence of neonatal abstinence syndrome (NAS), a drug withdraw syndrome mainly associated with intrauterine opioid exposure, has increased considerably in the United States since 2000. Nonpharmacological options, including breastfeeding, may be effective at improving outcomes in this population. The objective of this population-based study was to examine the association between breastfeeding and length of hospital stay among infants diagnosed with NAS.
This was a retrospective cohort study of singleton in-hospital births to resident mothers in Pennsylvania. Hospital discharge data from births occurring between 2012 through 2014 were linked with corresponding birth certificate data. International Classification of Diseases, Ninth Revision, Clinical Modification discharge diagnosis codes were used to identify NAS neonates (N = 3,725). Breastfeeding at discharge was used to determine breastfeeding status. Infant and maternal characteristics were compared by breastfeeding status and the association between breastfeeding and infant length of hospitalization was assessed.
Less than one-half of infants diagnosed with NAS were breastfed at discharge. Significant differences in infant birth weight and gestational age, and maternal education, marital status, prenatal care, smoking, and insurance status were found by breastfeeding status. A significant inverse relationship existed between breastfeeding and hospital length of stay for infants diagnosed with NAS. Specifically, length of hospitalization was reduced by 9.4% in the breastfed group compared to the nonbreastfed group.
Breastfeeding may be beneficial for infants diagnosed with NAS by shortening the length of hospital stay. Future prospective studies are warranted to further examine the benefits of breastfeeding and other nonpharmaceutical interventions in NAS populations.
自2000年以来，新生儿戒断综合征（NAS）在美国的发病率大幅上升，这是一种主要与宫内阿片类药物暴露相关的药物戒断综合征。包括母乳喂养在内的非药物选择可能对改善这一人群的预后有效。本基于人群的研究目的是探讨母乳喂养与诊断为NAS的婴儿住院时间之间的关联。
这是一项对宾夕法尼亚州常住母亲单胎住院分娩的回顾性队列研究。2012年至2014年期间出生的医院出院数据与相应的出生证明数据相关联。使用国际疾病分类第九版临床修订版出院诊断代码来识别NAS新生儿（N = 3725）。出院时的母乳喂养情况用于确定母乳喂养状态。通过母乳喂养状态比较婴儿和母亲的特征，并评估母乳喂养与婴儿住院时间之间的关联。
诊断为NAS的婴儿中，出院时进行母乳喂养的不到一半。根据母乳喂养状态，发现婴儿出生体重和胎龄以及母亲教育程度、婚姻状况、产前护理、吸烟和保险状况存在显著差异。诊断为NAS的婴儿，母乳喂养与住院时间之间存在显著的负相关关系。具体而言，与非母乳喂养组相比，母乳喂养组的住院时间缩短了9.4%。
母乳喂养可能通过缩短住院时间对诊断为NAS的婴儿有益。未来有必要进行前瞻性研究，以进一步探讨母乳喂养和其他非药物干预措施对NAS人群的益处。
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