Brandt Laura, Finnegan Loretta P
aDepartment of Applied Psychology: Work, Education and Economy, Faculty of Psychology, University of Vienna, Vienna, Austria bThe College on Problems of Drug Dependence, Inc., Philadelphia, Pennsylvania; Finnegan Consulting LLC, Avalon, New Jersey; Office of Research on Women's Health, National Institutes of Health, Bethesda, Maryland, USA.
Curr Opin Psychiatry. 2017 Jul;30(4):268-274. doi: 10.1097/YCO.0000000000000334.
Over the last 15 years the prevalence of neonatal abstinence syndrome (NAS) increased almost five-fold. A considerable diversity seems to prevail in the management of NAS. This review provides an overview of factors affecting the expression and course of NAS, and recent developments in NAS assessment and treatment.
Apart from different pharmacological and nonpharmacological treatment modalities, maturity of the infant and genetic variations likely are (co)responsible for interpatient variability in NAS severity, despite similar maternal exposure. Recent efforts concerning the further development of NAS severity scoring systems focus on the development of brief screening measures; in addition, pupil diameter and skin conductance have been proposed as complements to observer-rated scales. The decrease in incidence of NAS begins in the appropriate management of medication assisted treatment of the mother.
Mitigating the negative outcomes for infants affected by NAS, their mothers and the healthcare system implies, first and foremost, developing and implementing an organized protocol for the management of NAS, and the homogenous use of a standardized scoring system utilizing interobserver reliability and a guide for medication initiation, maintenance, and weaning which is consistent with traditional methods of treatment for neonates.
在过去15年中，新生儿戒断综合征（NAS）的患病率几乎增长了五倍。NAS的管理似乎存在相当大的差异。本综述概述了影响NAS表现和病程的因素，以及NAS评估和治疗的最新进展。
除了不同的药物和非药物治疗方式外，尽管母亲接触情况相似，但婴儿的成熟度和基因变异可能（共同）导致了NAS严重程度的个体差异。近期关于进一步开发NAS严重程度评分系统的努力主要集中在开发简短筛查措施上；此外，瞳孔直径和皮肤电导率已被提议作为观察者评分量表的补充。NAS发病率的降低始于对母亲药物辅助治疗的适当管理。
减轻受NAS影响的婴儿、其母亲和医疗系统的负面后果，首先意味着要制定并实施一套有组织的NAS管理方案，统一使用标准化评分系统，该系统要利用观察者间的可靠性，并提供与传统新生儿治疗方法一致的药物起始、维持和撤药指南。
