Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota.
Corresponsing author: Kathryn M. Schak, MD, Department of Psychiatry and Psychology, Mayo Clinic, 200 First St SW, Rochester, MN 55905 (
Prim Care Companion CNS Disord. 2021 Jun 10;23(3):20m02737. doi: 10.4088/PCC.20m02737.
To compare outcomes among newborns of opioid-using and nonopioid drug-using mothers with those of control mothers who did not report substance use. Using the Rochester Epidemiology Project, newborns diagnosed with drug withdrawal syndrome (per or codes) from January 2010 through June 2017 were identified. For mothers, data collected included age, race, drug use, number of prenatal visits, and results of the urinary drug abuse survey, meconium test, and self-report survey. Demographic and perinatal data collected for newborns included birth date; sex; Apgar scores at 1, 5, and 10 minutes; neonatal intensive care stay; and vital status. Controls (n = 771) were similarly selected in regard to sex, birth date, and county. Of 328 infants identified, 168 were born with opioid neonatal abstinence syndrome and 160 with a nonopioid withdrawal syndrome. Control mothers had more prenatal visits than mothers in the nonopioid and opioid groups. Newborns of control mothers had higher Apgar scores at 1 and 5 minutes than both substance-using groups. Opioid-using mothers were almost twice as likely to have newborns requiring intensive care and 3 times as likely to use benzodiazepines compared to the other substance-using mothers. Substance-using mothers had more premature babies than controls. Prenatal opioid use is a substantial risk factor for prematurity. Newborns diagnosed with neonatal abstinence syndrome are at risk of perinatal complications. Mothers using opioids during pregnancy also tend to use other substances. Longitudinal research should clarify how prenatal substance use interacts with other risk factors during a child's first years.
比较阿片类药物使用和非阿片类药物使用的母亲所生新生儿与未报告物质使用的对照母亲所生新生儿的结局。利用罗切斯特流行病学项目，确定了 2010 年 1 月至 2017 年 6 月期间被诊断为药物戒断综合征（按或 代码）的新生儿。对于母亲，收集的数据包括年龄、种族、药物使用、产前检查次数以及尿液药物滥用调查、胎粪检测和自我报告调查的结果。收集的新生儿人口统计学和围产期数据包括出生日期；性别；1 分钟、5 分钟和 10 分钟时的 Apgar 评分；新生儿重症监护病房停留时间；以及生命状态。对照（n=771）在性别、出生日期和县方面也进行了类似选择。在 328 名被确定的婴儿中，有 168 名患有阿片类新生儿戒断综合征，160 名患有非阿片类戒断综合征。与非阿片类和阿片剂组相比，对照组母亲的产前检查次数更多。对照组母亲的新生儿在 1 分钟和 5 分钟时的 Apgar 评分均高于两组物质使用组。与其他物质使用的母亲相比，使用阿片类药物的母亲的新生儿更有可能需要重症监护，使用苯二氮䓬类药物的可能性也高出三倍。物质使用的母亲比对照组有更多的早产儿。产前阿片类药物使用是早产的一个重要危险因素。被诊断患有新生儿戒断综合征的新生儿有围产期并发症的风险。母亲在怀孕期间使用阿片类药物也往往会使用其他物质。纵向研究应阐明产前物质使用如何与儿童头几年的其他风险因素相互作用。
