Office of the Assistant Secretary for Health, U.S. Department of Health and Human Services, Washington, DC, USA.
Division of Extramural Research, National Institute on Drug Abuse, Rockville, MD, USA.
J Perinatol. 2021 Jun;41(6):1364-1371. doi: 10.1038/s41372-020-00893-8. Epub 2021 Jan 29.
Neonatal abstinence syndrome (NAS) results from discontinuation of in utero exposures to opioids/substances. The rising incidence of NAS has prompted an increased need for accurate research and public health data. To examine how NAS has been defined in clinical studies of opioid-exposed mothers and infants, a review process was developed based on the RAND/UCLA Appropriateness Method, yielding 888 abstracts. Per inclusion criteria, 57 abstracts underwent full-text review. To define NAS, studies cited using modified versions of the Finnegan NAS scoring tool (n = 21; 37%), ICD-9/10 coding (n = 17; 30%), original Finnegan tool (n = 16; 28%), Eat Sleep Console (n = 3; 5%), and Lipsitz (n = 3; 5%) tools, (3 cited 2+ tools). Most studies utilized subjective NAS scoring/assessment algorithms and neonatal coding as key elements defining NAS. While most cited opioid exposure as integral to their inclusion criteria, 26% did not. These approaches highlight the need for a more refined and standardized definition of NAS.
新生儿戒断综合征（NAS）是由于胎儿停止接触阿片类药物/物质引起的。NAS 的发病率不断上升，这促使人们对准确的研究和公共卫生数据的需求增加。为了研究 NAS 在接受阿片类药物的母亲和婴儿的临床研究中是如何定义的，我们根据 RAND/UCLA 适宜性方法制定了审查程序，产生了 888 份摘要。根据纳入标准，对 57 份摘要进行了全文审查。为了定义 NAS，使用改良版芬纳根 NAS 评分工具（n=21；37%）、ICD-9/10 编码（n=17；30%）、原始芬纳根工具（n=16；28%）、Eat Sleep Console（n=3；5%）和 Lipsitz 工具（n=3；5%）的研究对 NAS 进行了定义（3 项研究引用了 2 种以上的工具）。大多数研究使用主观的 NAS 评分/评估算法和新生儿编码作为定义 NAS 的关键要素。尽管大多数研究都将阿片类药物暴露作为纳入标准的重要组成部分，但仍有 26%的研究未将其纳入。这些方法突出了需要对 NAS 进行更精确和标准化的定义。
