Penn State Milton S. Hershey Medical Center, Penn State College of Medicine, Department of Pediatrics, Hershey, PA, USA.
Penn State College of Medicine, Department of Public Health Sciences, Hershey, PA, USA.
J Dev Orig Health Dis. 2022 Feb;13(1):120-127. doi: 10.1017/S2040174421000052. Epub 2021 Mar 2.
Newborns with neonatal abstinence syndrome (NAS) display symptoms related to neurologic excitability and autonomic dysfunction that result in increased metabolic demands. These infants also exhibit feeding difficulties and/or hyperphagia. Because the effects of these symptoms and behaviors on growth are unknown, we sought to measure serial body composition measurements over the first 4 months in infants with NAS requiring pharmacologic treatment using air displacement plethysmography. Fourteen infants of singleton birth with appropriate-for-gestational-age (AGA) weight and a gestational age of ≥35 weeks and <42 weeks were evaluated. In mixed-effects models, per week, infants increased in mean fat percent by 1.1% (95% confidence interval [CI]: 0.85-1.43), fat mass by 90 g (CI: 70-100), and fat-free mass by 140 g (CI: 130-150). The subgroup of infants (N = 5) requiring multidrug therapy for symptom control had lower mean fat percent (-1.2%, CI: -5.2-2.1), fat mass (-60 g, CI: -25-13), and fat-free mass (-270 g, CI: -610-80) across time compared to infants requiring monotherapy. We are the first to report how body composition measures change over time in a small group of patients with NAS. Infants with NAS were smaller and leaner in the first several weeks compared to previously reported body composition measurements in term infants, but grew similarly to their healthy counterparts by 16 weeks. Infants with more severe NAS may be at risk for abnormalities in longer term growth.
患有新生儿戒断综合征（NAS）的新生儿表现出与神经兴奋性和自主功能障碍相关的症状，这导致代谢需求增加。这些婴儿还表现出喂养困难和/或食欲过盛。由于这些症状和行为对生长的影响尚不清楚，我们试图使用空气置换体描记法测量需要药物治疗的 NAS 婴儿在出生后 4 个月内的系列身体成分测量值。对 14 名出生时为适当胎龄（AGA）体重、胎龄为≥35 周至<42 周的单胎婴儿进行了评估。在混合效应模型中，婴儿每周平均脂肪百分比增加 1.1%（95%置信区间[CI]：0.85-1.43），脂肪量增加 90 克（CI：70-100），脂肪量增加 140 克（CI：130-150）。需要多药治疗以控制症状的婴儿亚组（N=5）的平均脂肪百分比（-1.2%，CI：-5.2-2.1）、脂肪量（-60 克，CI：-25-13）和去脂体重（-270 克，CI：-610-80）在整个时间内均低于接受单药治疗的婴儿。我们是第一个报告 NAS 患者的身体成分如何随时间变化的小组。与足月婴儿以前报告的身体成分测量值相比，患有 NAS 的婴儿在前几周内更小、更瘦，但到 16 周时与健康婴儿的生长情况相似。患有更严重 NAS 的婴儿可能存在长期生长异常的风险。
