评估母亲阿片类药物维持剂量对NOWS-COS结果标准的影响:试点研究
Danielle Smith1, Rhea Sullivan1, Emma C Allen1
1Division of Neonatal-Perinatal Medicine, Department of Pediatrics, Penn State College of Medicine, Hershey, PA, USA.
Clinical pediatrics
|April 17, 2024
概括
母亲的阿片类药物维持治疗剂量会影响婴儿的结果. 较高剂量与更长的症状控制持续时间和在产前暴露于阿片类维持疗法的婴儿中增加发育延迟率相关.
科学领域:
- 产科和妇科 产科和妇科
- 新生儿医学 新生儿医学
- 药理学 药理学是指药理学的学科.
背景情况:
- 片维持疗法 (OMT) 对于在怀孕期间管理阿片类药物使用障碍至关重要.
- 产前OMT暴露后婴儿的结果需要进一步调查,特别是关于剂量影响.
- 吗啡毫克相当量 (MME) 为比较分析标准化阿片类药物剂量.
研究的目的:
- 为了确定在怀孕期间母亲的OMT剂量是否会影响婴儿的结果.
- 分析母体吗啡毫克相当剂量 (MME) 与新生儿戒断综合征 (NAS) 严重程度和发育里程碑之间的关联.
- 确定与高剂量OMT在孕妇中相关的潜在风险.
主要方法:
- 追溯性对77个母婴二合体的队列研究,其中包括满期怀孕和产前OMT暴露.
- 母亲的OMT剂量被转换为MMEs,并分为高剂量 (>1000 mg) 和低剂量 (≤1000 mg) 组.
- 婴儿的结果,包括症状控制的几天和24个月的发育延迟,在剂量组之间使用统计测试进行了比较.
主要成果:
- 暴露于高剂量的母体OMT (MME>1000毫克) 的婴儿需要显著更多的天才能达到症状控制 (5天对2.8天,P = .016).
- 在高剂量OMT组中,24个月的发育延迟率明显高于高剂量OMT组 (21.2%对4.5%,P = .0335).
- 母亲MME剂量没有预测新生儿戒断综合征 (NOWS) 治疗的需要.
结论:
- 较高的母体OMT剂量 (MME>1000毫克) 与症状持续时间延长和婴儿发育延迟风险增加有关.
- 优化非药物干预的安慰建议婴儿暴露于更高的MME剂量.
- 密切监测发育迟缓迹象对于产前暴露于较高母体OMT剂量的婴儿至关重要.
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