Fabris C, Prandi G, Perathoner C, Soldi A
Department of Neonatology, Turin University, Italy.
Panminerva Med. 1998 Sep;40(3):239-43.
In the twenty years since the first case of neonatal drug addiction (resulting from the mother's use during pregnancy of morphine, heroin, methadone, cocaine) was referred to our attention, there has been a steady increase in the number of cases per year. Heroin alone or in association with methadone now represents the drug used by approximately 80% of addicted mothers. Over the past few years the mean age of mothers has increased; the number of drug users who do not appear to be addicts has also increased and a number of cases have lately been discovered only on the basis of neonatal symptoms, without any previous anamnestic indication. Neonatal abstinence syndrome (NAS) is the most striking effect of fetal exposure to drugs. Symptoms are easily recognised; pharmacological treatment can consist of either sedatives or replacement drugs whose dosage depends on the severity of withdrawal symptoms evaluated using a score system. NAS symptoms are usually resolved within a few days although some signs, especially irritability and tremors, may persist until 3 months of age. The main concern at present regards the future of these neonates. The most severe risk to which they are exposed, after HIV infection, is social; during the past few years in over 50% of cases parental authority has been suspended by the juvenile court. No long-term neurologic or cognitive deficits are directly associated with heroin or methadone use during pregnancy.
自第一例新生儿药物成瘾（因母亲在孕期使用吗啡、海洛因、美沙酮、可卡因所致）引起我们的关注至今已有二十年，每年的病例数一直在稳步增加。仅海洛因或海洛因与美沙酮联用，目前约占成瘾母亲所使用药物的80%。在过去几年中，母亲的平均年龄有所增加；看似未成瘾的吸毒者数量也有所增加，且最近有一些病例仅根据新生儿症状才被发现，此前并无任何既往病史提示。新生儿戒断综合征（NAS）是胎儿接触药物最显著的影响。症状易于识别；药物治疗可使用镇静剂或替代药物，其剂量取决于使用评分系统评估的戒断症状的严重程度。NAS症状通常在数天内缓解，不过一些体征，尤其是易激惹和震颤，可能会持续至3个月大。目前主要担忧的是这些新生儿的未来。在感染艾滋病毒之后，他们面临的最严重风险是社会风险；在过去几年中，超过50%的案例中父母监护权已被少年法庭暂停。孕期使用海洛因或美沙酮与长期的神经或认知缺陷并无直接关联。
