Neonatal Abstinence Syndrome.
Neonatal Abstinence Syndrome.
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DOI：
10.1016/j.pcl.2018.12.006
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发表时间：
2019-04
影响因子：
2.6
通讯作者：
Patrick SW
中科院分区：
文献类型：
--
作者：
Jansson LM;Patrick SW
在过去的20年里，阿片类药物的使用在美国急剧增长。2015年，37%的美国成年人被处方至少一种阿片类止痛药（OPR），是1999年的1-3倍。[2]虽然OPR的使用在美国各地仍然很高，但最近海洛因和芬太尼的消费以及这些药物过量的死亡人数大幅增加。美国各地阿片类药物使用的增加与许多人群的并发症有关，包括孕妇和婴儿。4新生儿戒断综合征（NAS）是一种出生后不久出现的戒断综合征，由妊娠期间使用阿片类药物（包括海洛因，使用或滥用处方止痛药，或母体治疗药物，如美沙酮或丁丙诺啡）的妇女所生婴儿。在孕妇使用阿片类药物增加的同时，从2000年到2014年，被诊断患有NAS的婴儿数量增长了近7倍。4-6到2014年，超过30，000名婴儿被诊断患有该综合征，住院费用超过5亿美元。6 NAS的增加不成比例地发生在农村地区7和其他阿片类药物相关并发症（包括过量死亡）发生率较高的美国州。8 NAS是一种复杂的疾病，在不同婴儿之间以及在同一婴儿中随着时间的推移在体征和严重程度的类型上都是不同的。每一个接触阿片类药物的婴儿都是独一无二的，并且沿着着一系列戒断症状。目前，没有办法准确预测任何给定婴儿中NAS表达的严重程度。NAS通常与母体使用或滥用阿片类药物（海洛因，处方止痛药）或与母体治疗药物（如美沙酮或丁丙诺啡）有关。然而，它的表达可以被许多母体、婴儿和环境因素改变（表1）。10-27妊娠期间接触的时间，与阿片类药物使用相关的母体压力
Over the previous 2 decades, use of opioids grew dramatically across the United States. In 2015, 37% of American adults were prescribed at least one opioid pain reliever (OPR) 1—3 times as many as in 1999. 2 Although OPR use remains elevated across the United States, more recently consumption of heroin and fentanyl and deaths from overdose of these drugs increased substantially. 3 Rising opioid use across the United States has been associated with complications among many populations, including pregnant women and infants. 4 Neonatal abstinence syndrome (NAS) is a postnatal withdrawal syndrome that manifests shortly after birth in infants born to women with opioid use (including heroin, use or misuse of prescription painkillers, or maternal treatment medications such as methadone or buprenorphine) during pregnancy. Concurrent with the increase in opioid use among pregnant women, the number of infants diagnosed with NAS grew nearly 7-fold from 2000 to 2014. 4–6 By 2014, more than 30,000 infants were diagnosed with the syndrome, accounting for more than $500 million in hospitalization costs. 6 Increases in NAS occurred disproportionately in rural areas7 and in US states with high rates of other opioid-related complications including overdose death. 8NAS is a complex disorder that is variably expressed, both in types of signs and severity, among different infants, and in the same infant over time. Every opioid-exposed infant is unique and resides along a continuum of signs of withdrawal. 9 Currently, there is no way to accurately predict the severity of NAS expression in any given infant. NAS is typically associated with maternal use or misuse of opioids (heroin, prescription painkillers), or with maternal treatment medications such as methadone or buprenorphine. However, its expression can be modified by many maternal, infant, and environmental factors (Table 1). 10–27 Timing of exposure during gestation, maternal stress associated with opioid use
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影响因子：
1.3
作者：
Jansson, Lauren M.;Velez, Martha
通讯作者：
Velez, Martha
影响因子：
39.2
作者：
Han, Beth;Compton, Wilson M.;Jones, Christopher M.
通讯作者：
Jones, Christopher M.
影响因子：
33.9
作者：
Guy, Gery P., Jr.;Zhang, Kun;Dowell, Deborah
通讯作者：
Dowell, Deborah
影响因子：
2.7
作者：
Jansson, Lauren M.;Bunik, Maya;Powers, Nancy G.
通讯作者：
Powers, Nancy G.
影响因子：
6
作者：
Kaltenbach, Karol;Holbrook, Amber M.;Jones, Hendree E.
通讯作者：
Jones, Hendree E.