多物质暴露对宫内阿片类药物暴露婴儿新生儿结局的影响。

Effects of polysubstance exposure on neonatal outcomes for infants with intrauterine opioid exposure.

机构信息

Department of Pediatrics, University of Washington, Seattle, WA, USA.

Division of Women and Children's, Providence St. Joseph's Health System, Renton, WA, USA.

出版信息

J Perinatol. 2020 Oct;40(10):1489-1496. doi: 10.1038/s41372-020-0717-y. Epub 2020 Jul 8.

DOI:10.1038/s41372-020-0717-y

PMID:32641774

Abstract

OBJECTIVE

Quantify the effect of prenatal polysubstance exposure on neonatal outcomes compared to methadone exposure alone.

STUDY DESIGN

This retrospective cohort study compared infants with methadone-only exposure to methadone with additional psychoactive substances. Outcomes included time to maximum Finnegan scores, proportion requiring scheduled morphine, and length of stay (LOS).

RESULTS

We identified 323 subjects. The median time to maximum Finnegan score was 38.0 h with 94% peaking within 96 h. Forty-five percent of methadone-only infants were started on scheduled morphine compared to 54% of polysubstance infants (p = 0.10). LOS for polysubstance-exposed infants was 1.30 times longer than infants with methadone-only exposure (95% confidence interval: 1.05, 1.60).

CONCLUSIONS

Exposure to methadone with additional psychoactive substances is associated with longer LOS, but not postnatal morphine use or peak withdrawal symptoms. Most infants experience peak withdrawal symptoms within 4 days and may not benefit from longer observation.

摘要

目的

与仅接触美沙酮相比，定量评估产前多物质暴露对新生儿结局的影响。

研究设计

这项回顾性队列研究比较了仅接触美沙酮的婴儿与接触美沙酮和其他精神活性物质的婴儿。结果包括达到最大芬尼根评分的时间、需要定期吗啡的比例和住院时间（ LOS ）。

结果

我们确定了 323 名受试者。达到最大芬尼根评分的中位数时间为 38.0 小时，94%的婴儿在 96 小时内达到高峰。与仅接受美沙酮的婴儿相比，45%的美沙酮和其他精神活性物质婴儿开始接受定期吗啡治疗（p=0.10）。接触多种物质的婴儿的 LOS 比仅接受美沙酮暴露的婴儿长 1.30 倍（95%置信区间：1.05，1.60）。