Management of neonatal abstinence syndrome in neonates born to opioid maintained women

被引:103
作者
Ebner, Nina
Rohrmeister, Klaudia
Winklbaur, Bernadette
Baewert, Andjela
Jagsch, Reinhold
Peternell, Alexandra
Thau, Kenneth
Fischer, Gabriele
机构
[1] Med Univ Vienna, Addict Clin, Dept Psychiat, A-1090 Vienna, Austria
[2] Med Univ Vienna, Dept Neonatol, A-1090 Vienna, Austria
[3] Univ Vienna, Fac Psychol, Dept Clin Biol & Differential Psychol, A-1010 Vienna, Austria
关键词
pregnancy; opioid dependence; maintenance therapy; neonatal abstinence syndrome (NAS);
D O I
10.1016/j.drugalcdep.2006.08.024
中图分类号
R194 [卫生标准、卫生检查、医药管理];
学科分类号
摘要
Neonates born to opioid-maintained mothers are at risk of developing neonatal abstinence syndrome (NAS), which often requires pharmacological treatment. This study examined the effect of opioid maintenance treatment on the incidence and timing of NAS, and compared two different NAS treatments (phenobarbital versus morphine hydrochloride). Fifty-three neonates born to opioid-maintained mothers were included in this study. The mothers received methadone (n = 22), slow-release oral morphine (n = 17) or buprenorphine (n = 14) throughout pregnancy. Irrespective of maintenance treatment, all neonates showed APGAR scores comparable to infants of non-opioid dependent mothers. No difference was found between the three maintenance groups regarding neonatal weight, length or head circumference. Sixty percent (n = 32) of neonates required treatment for NAS [68% in the methadone-maintained group (n = 15), 82% in the morphine-maintained group (n = 14), and 21% in the buprenorphine-maintained group (n = 3)]. The mean duration from birth to requirement of NAS treatment was 33 h for the morphine-maintained group, 34 h for the buprenorphine-maintained group and 58 h for the methadone-maintained group. In neonates requiring NAS treatment, those receiving morphine required a significantly shorter mean duration of treatment (9.9 days) versus those treated with phenobarbital (17.7 days). Results suggest that morphine hydrochloride is preferable for neonates suffering NAS due to opioid withdrawal. (c) 2006 Elsevier Ireland Ltd. All rights reserved.
引用
收藏
页码:131 / 138
页数:8
相关论文
共 64 条
[1]  
[Anonymous], 1990, Modern methods in pharmacology
[2]   Maintenance therapy with synthetic opioids within a multidisciplinary program - A stabilizing necessity for pregnant opioid dependent women [J].
Fischer G. ;
Eder H. ;
Jagsch R. ;
Lennkh C. ;
Habeler A. ;
Aschauer H.N. ;
Kasper S. .
Archives of Women's Mental Health, 1998, 1 (3) :109-116
[3]  
[Anonymous], 1994, AM PSYCHIATR ASSOC
[4]  
APGAR V, 1996, PEDIATR CLIN N AM, V13, P645
[5]  
Auriacombe M, 1999, PRESSE MED, V28, P177
[6]   CLINICAL PHARMACOKINETICS OF ANTIEPILEPTIC DRUGS IN PEDIATRIC-PATIENTS .1. PHENOBARBITAL, PRIMIDONE, VALPROIC ACID, ETHOSUXIMIDE AND MESUXIMIDE [J].
BATTINO, D ;
ESTIENNE, M ;
AVANZINI, G .
CLINICAL PHARMACOKINETICS, 1995, 29 (04) :257-286
[7]   Maternal methadone dose and neonatal withdrawal [J].
Berghella, V ;
Lim, PJ ;
Hill, MK ;
Cherpes, J ;
Chennat, J ;
Kaltenbach, K .
AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY, 2003, 189 (02) :312-317
[8]  
Berlin CM, 1998, PEDIATRICS, V101, P1079
[9]   Methadone maintenance in pregnancy: A reappraisal [J].
Brown, HL ;
Britton, KA ;
Mahaffey, D ;
Brizendine, E ;
Hiett, AK ;
Turnquest, MA .
AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY, 1998, 179 (02) :459-463
[10]  
CHIANG CN, 1995, NIDA RES MONOGR US D, P149