Neonatal neurobehavior effects following buprenorphine versus methadone exposure.
Neonatal neurobehavior effects following buprenorphine versus methadone exposure.
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DOI：
10.1111/j.1360-0443.2012.04040.x
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发表时间：
2012-11
期刊：
影响因子：
--
通讯作者：
Fischer G
中科院分区：
文献类型：
--
作者：
Coyle MG;Salisbury AL;Lester BM;Jones HE;Lin H;Graf-Rohrmeister K;Fischer G
确定宫内暴露于美沙酮或丁丙诺啡对婴儿神经行为的影响。母体阿片类药物治疗：人体实验研究（MOTHER）研究（一项双盲、双模拟、随机临床试验）的三个研究中心参与了该子研究。医疗中心，为巴尔的摩，MD，普罗维登斯，RI和维也纳，奥地利的阿片类药物依赖孕妇提供全面的孕产妇护理。39个足月婴儿。在产后第3、5、7、10、14-15和28-30天对一组婴儿进行NICU网络神经行为量表（NNNS）。虽然随着时间的推移，两种药物条件下的神经行为都有所改善，但子宫内暴露于丁丙诺啡的婴儿表现出较少的压力-戒断症状（P<0.001），兴奋性较低（P<0.001）和更少的过度唤醒（P<0.01），肌张力增高明显减轻（P<0.007），自我调节能力较好（P<0.04），维持安静警觉状态所需的处理较少（P<0.001）。开始吗啡戒断治疗时年龄较大的婴儿具有较高的自我调节评分（P<0.01），平均表现出最少的兴奋性（P<0.02）和张力亢进（P<0.02）。运动质量与NAS最高评分（P<0.01）、因NAS使用吗啡天数（P<0.01）和吗啡用量（P<0.03）呈负相关。兴奋性评分与吗啡总用量呈正相关（P<0.03）。虽然宫内激动剂药物暴露的新生儿在出生后第一个月的神经行为得到改善，但丁丙诺啡暴露导致上级神经行为评分和较美沙酮暴露更轻的戒断症状。
To determine the effects of in utero exposure to methadone or buprenorphine on infant neurobehavior. Three sites from the Maternal Opioid Treatment: Human Experimental Research (MOTHER) study, a double-blind, double-dummy, randomized clinical trial participated in this sub-study. Medical Centers that provided comprehensive maternal care to opioid-dependent pregnant women in Baltimore, MD, Providence, RI, and Vienna, Austria. 39 full-term infants. The NICU Network Neurobehavioral Scale (NNNS) was administered to a subgroup of infants on postpartum days 3, 5, 7, 10, 14-15 and 28-30. While neurobehavior improved for both medication conditions over time, infants exposed in utero to buprenorphine exhibited fewer Stress-Abstinence signs (P<0.001), were less Excitable (P<0.001) and less Over-Aroused (P<0.01), exhibited less Hypertonia (P<0.007), and had better Self-Regulation (P<0.04) and required less Handling (P<0.001) to maintain a quiet alert state relative to in utero methadone-exposed infants. Infants who were older when they began morphine treatment for withdrawal had higher Self-Regulation scores (P<0.01), and demonstrated the least amount of Excitability (P<0.02) and Hypertonia (P<0.02) on average. Quality of Movement was negatively correlated with peak NAS score (P<0.01), number of days treated with morphine for NAS (P<0.01) and total amount of morphine received (P<0.03). Excitability scores were positively related to total morphine dose (P<0.03). While neurobehavior improves during the first month of postnatal life for in utero agonist-medication-exposed neonates, buprenorphine exposure results in superior neurobehavioral scores and less severe withdrawal than does methadone exposure.
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影响因子：
2
作者：
Jones, Hendree E.;O'Grady, Kevin E.;Jansson, Lauren M.
通讯作者：
Jansson, Lauren M.
影响因子：
5.1
作者：
Coyle, MG;Ferguson, A;Lester, B
通讯作者：
Lester, B
影响因子：
5.1
作者：
Stroud, Laura R.;Paster, Rachel L.;Lester, Barry
通讯作者：
Lester, Barry
DOI：
10.1016/s0889-8545(05)70362-4
发表时间：
1998-03-01
影响因子：
3.2
作者：
Kaltenbach, K;Berghella, V;Finnegan, L
通讯作者：
Finnegan, L
影响因子：
6
作者：
Fischer, G;Ortner, R;Aschauer, H
通讯作者：
Aschauer, H