Penn State College of Medicine, Department of Pediatrics, P.O. Box 850, 500 University Drive, Hershey, PA, 17033-0850, USA.
Penn State College of Medicine, Department of Public Health Sciences, Hershey, PA, USA.
BMC Pediatr. 2018 Nov 5;18(1):343. doi: 10.1186/s12887-018-1327-0.
Infants with neonatal abstinence syndrome (NAS) initially experience neurologic excitability, poor feeding, and/or hyperphagia in the setting of increased metabolic demand. Because the longitudinal effects of these early symptoms and behaviors on weight trends are unknown, we sought to contrast weight gain patterns through age 1 year for infants diagnosed with NAS with matched controls.
Retrospective cohort of 70 singletons with a gestational age of ≥37 weeks and an ICD-9 or ICD-10 diagnosis of NAS made ≤7 days after birth with institutional follow-up matched to patients without NAS. Infants were matched on gestational age (±2 weeks), birth weight (±20 g), sex (exact), and insurance type (exact). Quantile regression methods were used to estimate 10th, 25th, 50th, 75th and 90th percentiles of weight over time.
The mean gestational age for an infant with NAS was 38.8 weeks (standard deviation [SD], 1.3). The mean birth weight was 3.141 kg (SD, 0.510). NAS patients had a median of 24 weights recorded between birth and 400 days (inter-quartile range [IQR], 16-32 weights). Patients without NAS had a median of 12 weights recorded (IQR, 10-16). Growth curves were similar over the first 400 days of life. Patients with NAS had non-significantly higher and lower estimated weights for the 90th and 10th percentiles, respectively.
Infants with a diagnosis of NAS grew similarly to controls during their first year. Given the frequently-encountered NAS symptoms of hyperphagia and irritability, future studies may evaluate whether early differences in caregiver feeding exist and whether they have longer-term impacts on growth.
患有新生儿戒断综合征（NAS）的婴儿在代谢需求增加的情况下最初会出现神经兴奋性、喂养不良和/或贪食。由于这些早期症状和行为对体重趋势的长期影响尚不清楚，我们试图通过 1 岁时的体重增长模式来对比诊断为 NAS 的婴儿与匹配对照组。
这是一项回顾性队列研究，纳入了 70 名胎龄≥37 周且在出生后≤7 天内通过 ICD-9 或 ICD-10 诊断为 NAS 的单胎婴儿，并与没有 NAS 的婴儿进行了机构随访匹配。婴儿按照胎龄（±2 周）、出生体重（±20 克）、性别（精确）和保险类型（精确）进行匹配。使用分位数回归方法来估计体重随时间的第 10、25、50、75 和 90 百分位数。
患有 NAS 的婴儿的平均胎龄为 38.8 周（标准差 [SD]，1.3）。平均出生体重为 3.141 公斤（SD，0.510）。NAS 患者在出生至 400 天之间记录了中位数为 24 次体重（四分位距 [IQR]，16-32 次）。没有 NAS 的患者记录了中位数为 12 次体重（IQR，10-16 次）。在生命的前 400 天，生长曲线相似。患有 NAS 的患者的第 90 和第 10 百分位数的估计体重分别偏高和偏低，但无统计学意义。
在他们的第一年，患有 NAS 诊断的婴儿与对照组的生长情况相似。鉴于 NAS 常见的过度进食和烦躁不安的症状，未来的研究可能会评估早期是否存在照顾者喂养的差异，以及这些差异是否对生长有长期影响。
