Methadone, cocaine, opiates, and metabolite disposition in umbilical cord and correlations to maternal methadone dose and neonatal outcomes.
Methadone, cocaine, opiates, and metabolite disposition in umbilical cord and correlations to maternal methadone dose and neonatal outcomes.
复制标题
美沙酮，可卡因，阿片类药物和代谢物处置以及与母美沙酮剂量和新生儿结局相关的相关性。
DOI：
10.1097/ftd.0b013e31822724f0
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发表时间：
2011-08
影响因子：
2.5
通讯作者：
Huestis MA
中科院分区：
文献类型：
--
作者：
de Castro A;Jones HE;Johnson RE;Gray TR;Shakleya DM;Huestis MA
探讨美沙酮和2-亚乙基-1，5-二甲基-3，3-二苯基吡咯烷（EDDP）在脐带中的分布，以及与母体美沙酮剂量和新生儿结局的相关性，并评估宫内违禁药物暴露的脐带药物检测窗口。受试者，19名阿片类药物依赖的孕妇从两个临床研究，一个比较美沙酮和丁丙诺啡药物治疗阿片类药物依赖治疗，第二个检查货币加固时间表，以保持药物戒断。计算美沙酮和EDDP脐带浓度和母体美沙酮剂量以及新生儿结局的相关性。将脐带中的可卡因和阿片类药物阳性浓度与胎盘和胎粪中的浓度以及整个妊娠期间收集的尿液样本进行比较。脐带血中美沙酮浓度与美沙酮平均日剂量、孕晚期平均剂量和美沙酮累积日剂量呈显著正相关。脐带EDDP浓度和EDDP/美沙酮浓度比值与新生儿身长、新生儿戒断综合征（NAS）评分峰值和NAS评分达峰时间呈正相关。脐带和胎盘中美沙酮浓度与EDDP/美沙酮比值呈正相关。胎粪比脐带鉴定出更多的可卡因和阿片类药物阳性标本。脐带血美沙酮浓度与美沙酮剂量相关。此外，我们的研究结果表明，美沙酮和EDDP浓度可能有助于预测NAS的严重程度。胎粪被证明比脐带更适合检测宫内暴露于可卡因和阿片类药物;然而，当胎粪由于宫内或延迟排出而不可用时，脐带可能是有用的。
To explore methadone and 2-ethylidene-1,5-dimethyl-3,3-diphenylpyrrolidine (EDDP) umbilical cord disposition, correlate with maternal methadone dose and neonatal outcomes, and evaluate the window of drug detection in umbilical cord of in utero illicit drug exposure. Subjects, 19 opioid-dependent pregnant women from two clinical studies, one comparing methadone and buprenorphine pharmacotherapy for opioid-dependence treatment, and the second examining monetary reinforcement schedules to maintain drug abstinence. Correlations were calculated for methadone and EDDP umbilical cord concentrations and maternal methadone dose, and neonatal outcomes. Cocaine- and opiate-positive umbilical cord concentrations were compared to those in placenta and meconium, and urine specimens collected throughout gestation. Significant positive correlations were found for umbilical cord methadone concentrations and methadone mean daily dose, mean dose during the 3rd trimester and methadone cumulative daily dose. Umbilical cord EDDP concentrations and EDDP/methadone concentration ratios were positively correlated to newborn length, peak neonatal abstinence syndrome (NAS) score and time-to-peak NAS score. Methadone concentrations and EDDP/methadone ratios in umbilical cord and placenta were positively correlated. Meconium identified many more cocaine and opiate positive specimens than umbilical cord. Umbilical cord methadone concentrations were correlated to methadone doses. Also, our results indicate that methadone and EDDP concentrations might help to predict NAS severity. Meconium proved to be more suitable than umbilical cord to detect in utero exposure to cocaine and opiates; however, umbilical cord could be useful when meconium is unavailable due to in utero or delayed expulsion.