Neonatal abstinence syndrome
Neonatal abstinence syndrome
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DOI：
10.1038/s41572-018-0045-0
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发表时间：
2018-11-22
影响因子：
81.5
通讯作者：
Jones, Hendree E.
中科院分区：
文献类型：
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作者：
Coyle, Mara G.;Brogly, Susan B.;Jones, Hendree E.
新生儿戒断综合征是指由于产前停止接触（通过胎盘转移）各种物质而引起的体征和症状。本书重点介绍妊娠期间使用阿片类药物引起的新生儿戒断综合征-新生儿阿片类药物戒断综合征（NOWS）。随着阿片类药物使用的全球流行率惊人地增加，NOWS的发病率也在增加。NOWS可以表现为不同的严重程度或根本没有，原因不明，但可能与多种因素有关，包括母亲（例如，吸烟和其他物质暴露）和新生儿（胎龄，性别和遗传学）。护理NOWS婴儿首先要解决阿片类药物使用障碍孕妇所经历的问题。同时发生的精神疾病、经济困难、亲密伴侣暴力、传染病和获得护理的机会有限在这些妇女中很常见，可能导致孕产妇和新生儿的不良后果。虽然目前还没有关于最佳NOWS管理的共识，但非药物干预（如母乳喂养和母婴同室）已成为优先事项，因为它们可以改善症状，而无需进一步暴露于阿片类药物。未经治疗的NOWS可能与婴儿早期的发病率有关，胎儿阿片类药物暴露的长期后果才刚刚开始被理解。
Neonatal abstinence syndrome refers to the signs and symptoms attributed to the cessation of prenatal exposure (via placental transfer) to various substances. This Primer focuses on neonatal abstinence syndrome caused by opioid use during pregnancy- neonatal opioid withdrawal syndrome (NOWS). As the global prevalence of opioid use has alarmingly increased, so has the incidence of NOWS. NOWS can manifest with varying severity or not at all, for unknown reasons, but is likely to be associated with multiple factors, both maternal (for example, smoking and additional substance exposures) and neonatal (gestational age, sex and genetics). Care for the infant with NOWS begins with addressing the issues experienced by pregnant women with opioid use disorder. Co-occurring mental illness, economic hardship, intimate partner violence, infectious diseases and limited access to care are common in these women and can result in poor maternal and neonatal outcomes. Although there is no consensus regarding optimal NOWS management, non-pharmacological interventions (such as breastfeeding and rooming-in of the mother and the baby) have become a priority, as they can ameliorate symptoms without the need for further opioid exposure. Untreated NOWS can be associated with morbidity in early infancy, and the long-term consequences of fetal opioid exposure are only beginning to be understood.