Review of the assessment and management of neonatal abstinence syndrome

被引：116

作者：

Bagley S.M. ^{[1
]}

Wachman E.M. ^{[2
]}

Holland E. ^{[3
]}

Brogly S.B. ^{[4
]}

机构：

[1] Section of General Internal Medicine, Boston University School of Medicine, 801 Mass Ave., Boston, 02118, MA

[2] Department of Pediatrics, Boston Medical Center, 771 Albany Street, Dowling 4N 4109, Boston, 02118, MA

[3] Department of Obstetrics and Gynecology, Boston Medical Center, 85 East Concord Street, Boston, 02118, MA

[4] Department of Epidemiology, Boston University School of Public Health, Talbot Building East, 715 Albany Street, Boston, 02115, MA

来源：

Addiction Science & Clinical Practice | / 9卷 / 1期

关键词：

Neonatal abstinence syndrome assessment; Neonatal abstinence syndrome management; Neonatal abstinence syndrome treatment;

D O I：

10.1186/1940-0640-9-19

中图分类号：

学科分类号：

摘要：

Neonatal abstinence syndrome (NAS) secondary to in-utero opioid exposure is an increasing problem. Variability in assessment and treatment of NAS has been attributed to the lack of high-quality evidence to guide management of exposed neonates. This systematic review examines available evidence for NAS assessment tools, nonpharmacologic interventions, and pharmacologic management of opioid-exposed infants. There is limited data on the inter-observer reliability of NAS assessment tools due to lack of a standardized approach. In addition, most scales were developed prior to the prevalent use of prescribed prenatal concomitant medications, which can complicate NAS assessment. Nonpharmacologic interventions, particularly breastfeeding, may decrease NAS severity. Opioid medications such as morphine or methadone are recommended as first-line therapy, with phenobarbital or clonidine as second-line adjunctive therapy. Further research is needed to determine best practices for assessment, nonpharmacologic intervention, and pharmacologic management of infants with NAS in order to improve outcomes. © 2014 Bagley et al.; licensee BioMed Central Ltd.

引用

共 58 条

[1]

Patrick S.W., Schumacher R.E., Benneyworth B.D., Krans E.E., McAllister J.M., Davis M.M., Neonatal abstinence syndrome and associated health care expenditures: United States, 2000-2009, JAMA, 307, 18, pp. 1934-1940, (2012)

[2]

Hayes M.J., Brown M.S., Epidemic of prescription opiate abuse and neonatal abstinence, JAMA, 307, pp. 1974-1975, (2012)

[3]

Jones H.E., Kaltenbach K., Heil S.H., Stine S.M., Coyle M.G., Arria A.M., O'Grady K.E., Selby P., Martin P.R., Fischer G., Neonatal abstinence syndrome after methadone or buprenorphine exposure, N Engl J Med, 363, 24, pp. 2320-2331, (2010)

[4]

Hudak M.L., Tan R.C., Neonatal drug withdrawal, Pediatrics, 129, 2, pp. e540-e560, (2012)

[5]

Jansson L.M., Velez M., Harrow C., The opioid-exposed newborn: Assessment and pharmacologic management, J Opioid Manag, 5, 1, pp. 47-55, (2009)

[6]

Wachman E.M., Newby P.K., Vreeland J., Byun J., Bonganzi A., Bauchner H., Philipp B.L., The relationship between maternal opioid agonists and psychiatric medications on length of hospitalization for neonatal abstinence syndrome, J Addict Med, 5, 4, pp. 293-299, (2011)

[7]

Kaltenbach K., Holbrook A.M., Coyle M.G., Heil S.H., Salisbury A.L., Stine S.M., Martin P.R., Jones H.E., Predicting treatment for neonatal abstinence syndrome in infants born to women maintained on opioid agonist medication, Addiction, 107, pp. 45-52, (2012)

[8]

Pritham U.A., Breastfeeding promotion for management of neonatal abstinence syndrome, J Obstet Gynecol Neonatal Nurs, 42, 5, pp. 517-526, (2013)

[9]

Wachman E.M., Hayes M.J., Brown M.S., Paul J., Harvey-Wilkes K., Terrin N., Huggins G.S., Aranda J.V., Davis J.M., Association of OPRM1 and COMT single-nucleotide polymorphisms with hospital length of stay and treatment of neonatal abstinence syndrome, JAMA, 309, 17, pp. 1821-1827, (2013)

[10]

Crocetti M.T., Amin D.D., Jansson L.M., Variability in the evaluation and management of opiate-exposed newborns in Maryland, Clin Pediatr, 46, 7, pp. 632-635, (2007)

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