Clinical markers of neonatal opioid withdrawal syndrome: onset, severity and longitudinal neurodevelopmental outcome

项目摘要/摘要 这是对我们现有的NIDA资助的基金的行政补充，该基金的标题是“新生儿临床标记物” 阿片戒断综合征：发病、严重程度和纵向神经发育结果“(R01DA049755)。 在美国，每15分钟就有一个婴儿出生时接触到阿片类药物，其中许多人患上了难治性疾病 治疗药物戒断综合征、新生儿阿片类药物戒断综合征(NOWS)。不幸的是，诊断结果 NOWS是高度主观的，仅根据护士的判断就包括“高声哭喊”。这个 目的测量NOWS婴儿哭声的声学特征是诊断NOWS的重要组成部分 《新生儿临床标记物》行政副刊积极奖的具体目的 阿片戒断综合征：发病、严重程度和纵向神经发育结局“(R01DA049755)： 目的1：确定神经行为、哭闹、产前阿片类药物和其他物质暴露情况 头发和社会人口学预测NOWS的发病和严重程度。 目的2：评估这些临床标记物的预测有效性，并测试NOWS的严重程度是否可以预测 6个月和18个月时神经发育受损。我们开发了一种基于计算机的哭泣分析器，它可以提取 婴儿哭声的声学特征。我们用哭声分析器来确定声音特征 NOWS婴儿的哭声，并开发了NOWS哭声“签名”，可以识别哪些婴儿患上NOWS 准确率为91%。然而，我们开发的哭闹技术在床边是不能使用的。这个 本行政副刊的具体目的是开发一个基于云的自动分析系统 婴幼儿哭声特征对NOWS的诊断价值。建议的软件将使我们能够 一种全自动系统，其中用户使用电话或其他设备记录新生儿托儿所中的婴儿哭声 连接的设备，并在几秒钟内收到诊断结果。本行政副刊将 提供基于云的软件，通过提供更准确、更可靠的诊断来改变临床实践 会影响NOWS的药物治疗，包括住院时间和 有可能改善这些婴儿的长期结局。

PROJECT SUMMARY/ABSTRACT This is an administrative supplement to our existing NIDA-funded grant entitled “Clinical markers of neonatal opioid withdrawal syndrome: onset, severity and longitudinal neurodevelopmental outcome” (R01DA049755). Every 15 minutes in the United States, an infant is born exposed to opioids, many of which develop the difficult to treat drug withdrawal syndrome, Neonatal Opioid Withdrawal Syndrome (NOWS). Unfortunately, the diagnosis of NOWS is highly subjective and includes “high pitched cry” simply based on the nurse’s judgement. The objective measurement of the acoustic characteristics of the cry in babies with NOWS is a pivotal component of the Specific Aims of the active award for this Administrative Supplement entitled “Clinical markers of neonatal opioid withdrawal syndrome: onset, severity and longitudinal neurodevelopmental outcome” (R01DA049755): Aim 1: Determine neurobehavioral, cry, prenatal opioid and other substance exposure measured via maternal hair, and sociodemographic predictors of NOWS onset and severity. Aim 2: Evaluate the predictive validity of these clinical markers and test whether NOWS severity predicts neurodevelopment impairment at 6 and 18 months. We developed a computer-based cry analyzer that extracts the acoustic features of an infant’s cry. We used the cry analyzer to determine the acoustic characteristics of the cries of babies with NOWS and developed a NOWS cry “signature” that can identify which babies develop NOWS with a 91% accuracy rate. However, the cry technology that we developed is not usable at the bedside. The Specific Aim of this Administrative Supplement Is to develop a cloud-based system for the automated analysis of infant cry acoustical characteristics for the diagnosis of NOWS. The proposed software will enable us to have a fully automatic system, where a user records a baby cry in the newborn nursery using a phone or other connected device, and within a few seconds, receives the diagnostic result. This Administrative Supplement will provide the cloud-based software to change clinical practice by providing a more accurate and reliable diagnosis of NOWS which will affect the pharmacological treatment of NOWS including length of hospital stay and potentially improve the long-term outcome of these infants.