Department of Family Medicine, Queen's University, Kingston, Ontario, Canada.
Department of Pediatrics, Queen's University, Kingston, Ontario, Canada.
Am J Perinatol. 2022 Jun;39(8):897-903. doi: 10.1055/s-0040-1719182. Epub 2020 Nov 17.
The practice of rooming-in for opioid-dependent infants was introduced as the standard of care at our hospital following a pilot study which demonstrated that such infants had shorter lengths of stay and were less likely to require pharmacological treatment. We sought to determine whether these benefits have continued, and whether outcomes support continuing to use rooming-in as standard care.
Opioid-dependent infants delivered at 36 weeks gestation or later between January 1, 2015, and December 31, 2019, were eligible for rooming-in. Charts were reviewed and data were extracted regarding maternal and infant conditions, whether neonatal pharmacological treatment was required, and total length of hospital stay. Outcomes were compared with two historical groups reported in a previous pilot study: 24 healthy near-term opioid-dependent newborns who were admitted directly to the neonatal intensive care unit (NICU) prior to the introduction of rooming-in (May 1, 2012-May 31, 2013), and 20 similar opioid-dependent infants who were the first to room-in at our hospital (September 1, 2013-September 30, 2014).
Only 3.5% of 57 infants who roomed-in during the 5-year study period required pharmacological treatment, compared with 15% who roomed-in during the first year of the program's introduction and 83.3% who had been admitted directly to the NICU. The median length of stay remained 5 days for infants rooming-in, compared with 24 days for opioid-dependent infants in the cohort admitted to the NICU.
Early observations of the benefits of rooming-in on neonatal outcomes were sustained. Infants allowed to room-in were significantly less likely to require initiation of pharmacotherapy and a prolonged hospital stay than similar infants prior to the implementation of rooming-in as standard care. A large proportion of the infants who might have benefited from rooming-in required admission to the NICU for reasons other than neonatal abstinence syndrome (NAS).
· Benefits of rooming-in for near-term opioid-dependent infants were sustained or increased.. · Rooming-in is sustainable as standard care for these newborns.. · Many infants required admission to NICU for reasons other than NAS..
在我们医院进行了一项试点研究后，将母婴同室的做法引入作为护理标准，该研究表明，这样的婴儿住院时间更短，不太可能需要药物治疗。我们试图确定这些益处是否持续存在，以及结果是否支持继续将母婴同室作为标准护理。
在 2015 年 1 月 1 日至 2019 年 12 月 31 日期间，妊娠 36 周或以上分娩的阿片类药物依赖婴儿有资格进行母婴同室。我们对病历进行了回顾，并提取了有关产妇和婴儿情况、是否需要新生儿药物治疗以及总住院时间的数据。结果与之前一项试点研究中报告的两个历史组进行了比较：24 名健康的接近足月的阿片类药物依赖新生儿，在母婴同室引入前直接入住新生儿重症监护病房（NICU）（2012 年 5 月 1 日至 2013 年 5 月 31 日），以及 20 名在我们医院首次母婴同室的类似阿片类药物依赖婴儿（2013 年 9 月 1 日至 2014 年 9 月 30 日）。
在 5 年的研究期间，只有 3.5%的 57 名母婴同室婴儿需要药物治疗，而在该项目引入的第一年有 15%的婴儿需要药物治疗，而 83.3%的婴儿直接入住 NICU。母婴同室婴儿的中位住院时间仍为 5 天，而入住 NICU 的阿片类药物依赖婴儿的中位住院时间为 24 天。
母婴同室对新生儿结局的早期益处得到了持续。与实施母婴同室作为标准护理之前的类似婴儿相比，允许母婴同室的婴儿明显不太可能需要开始药物治疗和延长住院时间。由于新生儿戒断综合征（NAS）以外的其他原因，有相当一部分婴儿需要入住 NICU。
·母婴同室对接近足月的阿片类药物依赖婴儿的益处持续或增加。·母婴同室作为这些新生儿的标准护理是可持续的。·许多婴儿因 NAS 以外的其他原因需要入住 NICU。
