Stephanie D. Sealschott, MS, RN, is PhD Candidate, College of Nursing, The Ohio State University, Columbus. Rita H. Pickler, PhD, RN, FAAN, is FloAnn Sours Easton Professor of Child and Adolescent Health, College of Nursing, The Ohio State University, Columbus. Christine A. Fortney, PhD, RN, is Assistant Professor, College of Nursing, The Ohio State University, Columbus. Michael T. Bailey, PhD, is Associate Professor of Pediatrics, The Ohio State University, and Principle Investigator, Center for Microbial Pathogenesis, Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, Ohio.
Nurs Res. 2020 Sep/Oct;69(5S Suppl 1):S66-S78. doi: 10.1097/NNR.0000000000000452.
Neonatal exposure and subsequent withdrawal from maternal substance use disorder are a growing problem and consequence of the current opioid epidemic. Neonatal abstinence syndrome (NAS) is defined by a specified cluster of symptoms with treatment guided by the expression and severity of these symptoms. The mechanisms or pathophysiology contributing to the development of NAS symptoms are not well known, but one factor that may influence NAS symptoms is the gut microbiota.
The purpose of this integrative review was to examine evidence that might show if and how the gut microbiota influence expression and severity of symptoms similar to those seen in NAS.
Using published guidelines, a review of research studies that focused on the gut microbiome and symptoms similar to those seen in NAS was conducted, using the Cochrane, EMBASE, and Scopus databases, from 2009 through 2019.
The review results included findings of aberrant microbial diversity, differences in microbial communities between study groups, and associations between specific taxa and symptoms. In studies involving interventions, there were reports of improved microbial diversity, community structure, and symptoms.
The review findings provide evidence that the gut microbiota may play a role in modifying variability in the expression and severity of symptoms associated with NAS. Future research should focus on examining the gut microbiota in infants with and without the syndrome as well as exploring the relationship between symptom expression and aberrant gut microbiota colonization in infants with NAS.
新生儿暴露于母体物质使用障碍并随后戒断是当前阿片类药物流行的一个日益严重的问题和后果。新生儿戒断综合征（NAS）的定义是一组特定的症状，这些症状的表达和严重程度指导着治疗。导致 NAS 症状发展的机制或病理生理学尚不清楚，但可能影响 NAS 症状的一个因素是肠道微生物群。
本次综合回顾的目的是研究是否以及如何通过肠道微生物群来影响类似于 NAS 所见的症状的表达和严重程度的证据。
根据已发表的指南，对 2009 年至 2019 年期间在考科兰、EMBASE 和 Scopus 数据库中发表的专注于肠道微生物群和类似于 NAS 所见症状的研究进行了回顾。
综述结果包括异常微生物多样性的发现、研究组之间微生物群落的差异，以及特定分类群与症状之间的关联。在涉及干预的研究中，有报告称微生物多样性、群落结构和症状得到改善。
综述结果提供了证据表明，肠道微生物群可能在调节与 NAS 相关的症状的表达和严重程度的可变性方面发挥作用。未来的研究应集中在检查有和没有该综合征的婴儿的肠道微生物群，并探索 NAS 婴儿中症状表达与异常肠道微生物群定植之间的关系。
