Clinical and laboratory characteristics of infants born to substance addicted mothers: a single center experience
DOI:
https://doi.org/10.51982/bagimli.1141958Keywords:
Neonatal abstinence syndrome, pregnancy, newbornAbstract
Objective: It is known that the use of alcohol, illicit drugs and psychoactive substances during pregnancy is significantly associated with maternal, fetal and neonatal morbidities. We planned to investigate the characteristics of babies born to mothers who use illicit substances.
Method: Babies born to mothers using illicit drugs and healthy babies born between September 2019 and December 2021 were included in the study. Demographic, clinical and laboratory data of the patients and modified Finnegan scores were recorded retrospectively from the file data.
Results: A total of 24 infants, 11 infants of drug-using mothers and 13 healthy infants in the control group, were included in the study. Ages of mothers, gestational weeks, birth weights, and APGAR scores at 1st and 5th minutes of babies born to mothers who used substance were found to be statistically lower than healthy babies. The rates of leukopenia and neutropenia were found to be significantly higher in patients with a modified Finnegan score ≥8 and in need of morphine (n:4/11) compared to patients without morphine need (n:7/11).
Conclusion: There is a need for detailed studies on the prevention of illicit substance use as a current health problem, the development of policies on early detection and follow-up, and the search for new biomarkers for the early detection of infants followed for neonatal withdrawal syndrome.
References
Hudak ML, Tan RC. Neonatal drug withdrawal. Pediatrics 2012; 129(2): e540-560. DOI: https://doi.org/10.1542/peds.2011-3212
Committee Opinion No. 711: Opioid use and opioid use disorder in pregnancy. Obstet Gynecol 2017; 130(2): e81-e94. DOI: https://doi.org/10.1097/AOG.0000000000002235
Finnegan LP, Connaughton JF Jr, Kron RE, Emich JP. Neonatal abstinence syndrome: assessment and management. Addict Dis 1975; 2(1-2): 141–158.
Costello EJ, Copeland WE, Shanahan L, et al. C-reactive protein and substance use disorders in adolescence and early adulthood: a prospective analysis. Drug Alcohol Depend 2013; 133(2): 712-717. DOI: https://doi.org/10.1016/j.drugalcdep.2013.08.027
Morcuende A, Navarrete F, Nieto E, et al. Inflammatory biomarkers in addictive disorders. Biomolecules 2021; 11(12): 1824. DOI: https://doi.org/10.3390/biom11121824
Ozkan N, Sonmez MB, Tas Durmus P, et al. Elevated neutrophil lymphocyte ratio in patients with substance use disorders. Eur Psychiatry 2017; 41(S1): S872-S(73. DOI: https://doi.org/10.1016/j.eurpsy.2017.01.1754
Özel Ş, Tayman C, ÜStÜN Y, et al. Evaluation of neonatal abstinence syndrome (Nas) frequency and systemic inflammatory response in Nas. Turkish Journal of Pediatric Disease 2019; 13(3): 171-176. DOI: https://doi.org/10.12956/tjpd.2018.357
Huestis MA, Choo RE. Drug abuse's smallest victims: in utero drug exposure. Forensic Sci Int 2002; 128(1-2): 20-30. DOI: https://doi.org/10.1016/S0379-0738(02)00160-3
WHO. Guidelines for identification and management of substance use and substance use disorders in pregnancy. Geneva: World Health Organization, 2014: 224.
Wong S, Ordean A, Kahan M. Substance use in pregnancy. J Obstet Gynaecol Can 2011; 33(4): 367-384. DOI: https://doi.org/10.1016/S1701-2163(16)34855-1
Lipsitz PJ. A proposed narcotic withdrawal score for use with newborn infants. A pragmatic evaluation of its efficacy. Clin Pediatr 1975; 14(6): 592-594. DOI: https://doi.org/10.1177/000992287501400613
Jansson LM, Velez M, Harrow C. The opioid-exposed newborn: assessment and pharmacologic management. J Opioid Manag 2009; 5(1): 47-55. DOI: https://doi.org/10.5055/jom.2009.0006
Kocherlakota P. Neonatal abstinence syndrome. Pediatrics 2014; 134(2): e547-e561. DOI: https://doi.org/10.1542/peds.2013-3524
Oji-Mmuo CN, Schaefer EW, Liao L, et al. The possibility of early discharge for newborns being monitored for neonatal abstinence syndrome based on modified finnegan score distributions. Clin Pediatr 2019; 58(6): 641646. DOI: https://doi.org/10.1177/0009922819832022
Orlando S. An overview of clinical tools used to assess neonatal abstinence syndrome. J Perinat Neonatal Nurs 2014; 28(3): 212-219. DOI: https://doi.org/10.1097/JPN.0000000000000043
Schiff DM, Grossman MR. Beyond the Finnegan scoring system: novel assessment and diagnostic techniques for the opioid-exposed infant. Semin Fetal Neonatal Med 2019; 24(2): 115-120. DOI: https://doi.org/10.1016/j.siny.2019.01.003
Verklan MT. Time for the Finnegan neonatal abstinence syndrome scoring tool to be retired? J Perinat Neonatal Nurs 2019; 33(3): 276-277. DOI: https://doi.org/10.1097/JPN.0000000000000427
Casper T, Arbour M. Evidence-based nurse-driven interventions for the care of newborns with neonatal abstinence syndrome. Adv Neonatal Care 2014; 14(6): 376-380. DOI: https://doi.org/10.1097/ANC.0000000000000118
Chervoneva I, Adeniyi-Jones SC, Blanco F, Kraft WK. Development of an abbreviated symptom score for the neonatal abstinence syndrome. J Perinatol 2020; 40(7): 1031-1040. DOI: https://doi.org/10.1038/s41372-020-0606-4
Clark AF. Effect of a neonatal abstinence syndrome training program on nurses' confidence and ability to use the Finnegan scoring tool. Nurs Womens Health 2019; 23(6): 485-493. DOI: https://doi.org/10.1016/j.nwh.2019.09.005
Corr TE, Hollenbeak CS. The economic burden of neonatal abstinence syndrome in the United States. Addiction 2017; 112(9): 1590-1599. DOI: https://doi.org/10.1111/add.13842
Hall ES, Wexelblatt SL, Crowley M, et al. A multicenter cohort study of treatments and hospital outcomes in neonatal abstinence syndrome. Pediatrics 2014; 134(2): e527-e534. DOI: https://doi.org/10.1542/peds.2013-4036
Raffaeli G, Cavallaro G, Allegaert K, et al. Neonatal abstinence syndrome: update on diagnostic and therapeutic strategies. Pharmacotherapy 2017; 37(7): 814-823. DOI: https://doi.org/10.1002/phar.1954
Grim K, Harrison TE, Wilder RT. Management of neonatal abstinence syndrome from opioids. Clin Perinatol 2013; 40(3): 509-524. DOI: https://doi.org/10.1016/j.clp.2013.05.004
Huybrechts KF, Bateman BT, Desai RJ, et al. Risk of neonatal drug withdrawal after intrauterine co-exposure to opioids and psychotropic medications: cohort study. BMJ 2017; 358: j3326. DOI: https://doi.org/10.1136/bmj.j3326
26. Behnke M, Eyler FD. The consequences of prenatal substance use for the developing fetus, newborn, and young child. Int J Addict 1993; 28(13): 1341-1391. DOI: https://doi.org/10.3109/10826089309062191
Shi X, DeLucia AL, Bao J, Zhang P. Alcohol abuse and disorder of granulopoiesis. Pharmacol Ther 2019; 198: 206-219. DOI: https://doi.org/10.1016/j.pharmthera.2019.03.001
Roy S, Wang J, Kelschenbach J, et al. Modulation of immune function by morphine: implications for susceptibility to infection. J Neuroimmune Pharmacol 2006; 1(1): 77-89. DOI: https://doi.org/10.1007/s11481-005-9009-8
Romanos-Sirakis E, Zureikat-Obeid R, Chein T, Demissie S. The evaluation of lymphopenia in infants exposed to opioids in-utero. J Neonatal Perinatal Med 2020; 13(1): 87-90. DOI: https://doi.org/10.3233/NPM-190279
Tolia VN, Patrick SW, Bennett MM, et al. Increasing incidence of the neonatal abstinence syndrome in U.S. neonatal ICUs. N Engl J Med 2015; 372(22): 2118-2126. DOI: https://doi.org/10.1056/NEJMsa1500439
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