Siddappa Ashajyothi M, Morris Erin, Evans Michael D, Pelinka Sarah, Adkisson Constance
Neonatology Department of Pediatrics Hennepin Healthcare, Minneapolis, Minnesota, USA.
Department of Pediatrics University of Minnesota, Minneapolis, Minnesota, USA.
Int J Pediatr. 2024 Aug 24;2024:2212688. doi: 10.1155/2024/2212688. eCollection 2024.
To assess inpatient growth parameter trajectories and to identify the type of opioid exposure and treatment characteristics influencing growth parameters of infants admitted to the newborn intensive care unit (NICU) for pharmacological treatment of neonatal opioid withdrawal syndrome (NOWS). Charts of term infants with NOWS admitted to NICU from 2012 to 2019, who received pharmacologic treatment, were reviewed. Intake (volume: mL/kg/day; calorie: kcal/kg/day) and growth parameter trajectories (weight, head circumference, and length) were analyzed based on the type of prenatal opioid exposure (short-acting opioids (SAOs), long-acting opioids (LAOs), and polysubstance), pharmacologic treatment, and sex. Growth measurement patterns over time were compared between groups using longitudinal mixed-effects models. One hundred nineteen infants were included in the study with median birth weight -score of -0.19 at birth and decreased to a median of -0.72 at discharge. Exposure to SAO was associated with an increase in -scores nearing discharge across all growth parameters (-score for weight = 0.03). Polysubstance exposure was associated with a decrease in -scores for length and head circumference throughout hospitalization. Infants with adjunct clonidine treatment had an increase in -score for weight trends. Male infants had a decrease in -scores for weight (male -0.96, female -0.59, interaction = 0.06) and length (male -1.17, female -0.57, interaction = 0.003) at Day 28. Despite the difference in growth trajectories, intake in terms of amount (mL/kg/day) and calorie intake (kcal/kg/day) was similar based on prenatal exposure, treatment, and sex. : Infants with NOWS requiring pharmacologic treatment have a decrease in -scores for weight, length, and head circumference at birth and at hospital discharge. Infants with prenatal polysubstance exposure were at particular risk for poorer inpatient growth relative to infants exposed to SAO and LAO, indicated by lower -scores for length and occipital frontal circumference (OFC).
评估住院婴儿的生长参数轨迹，并确定影响入住新生儿重症监护病房（NICU）接受新生儿阿片类药物戒断综合征（NOWS）药物治疗的婴儿生长参数的阿片类药物暴露类型和治疗特征。回顾了2012年至2019年入住NICU并接受药物治疗的患有NOWS的足月儿的病历。根据产前阿片类药物暴露类型（短效阿片类药物（SAO）、长效阿片类药物（LAO）和多物质）、药物治疗和性别，分析摄入量（体积：mL/kg/天；热量：kcal/kg/天）和生长参数轨迹（体重、头围和身长）。使用纵向混合效应模型比较各组随时间的生长测量模式。119名婴儿纳入研究，出生时体重中位数评分-0.19，出院时降至中位数-0.72。在所有生长参数方面，接近出院时SAO暴露与评分增加相关（体重评分=0.03）。多物质暴露与住院期间身长和头围评分降低相关。接受可乐定辅助治疗的婴儿体重趋势评分增加。在第28天，男婴体重评分（男-0.96，女-0.59，交互作用=0.06）和身长评分（男-1.17，女-0.57，交互作用=0.003）降低。尽管生长轨迹存在差异，但基于产前暴露、治疗和性别，摄入量（mL/kg/天）和热量摄入量（kcal/kg/天）相似。结论：需要药物治疗的NOWS婴儿在出生时和出院时体重、身长和头围评分降低。相对于暴露于SAO和LAO的婴儿，产前多物质暴露的婴儿住院生长较差的风险尤其高，表现为身长和枕额周长（OFC）评分较低。
