アブストラクト
Japanese
| Title | 妊婦が内服しているどの種類の向精神薬と出生した児の新生児薬物離脱スコアが関連しているのか |
|---|---|
| Subtitle | 原著 |
| Authors | 中山栗太*1*2, 宇都宮剛*1, 増田祥行*1, 中田あゆみ*1, 三崎真生子*1, 香田翼*1, 柴田暁男*1, 清野仁美*3, 奥田真珠美*1, 松永寿人*3, 柴原浩章*4, 竹島泰弘*1 |
| Authors (kana) | |
| Organization | *1兵庫医科大学 小児科学, *2公立豊岡病院 小児科・新生児科, *3兵庫医科大学 精神科神経科学, *4兵庫医科大学 産科婦人科学 |
| Journal | 日本新生児成育医学会雑誌 |
| Volume | 33 |
| Number | 3 |
| Page | 567-573 |
| Year/Month | 2021 / 10 |
| Article | 原著 |
| Publisher | 日本新生児成育医学会 |
| Abstract | 「要旨」,母体が内服する向精神薬により新生児薬物離脱症候群がおこりうる. 2016年から2019年に当院で母体が向精神,薬を1剤以上内服していた症例を対象に, 児の性別, 出生体重, 在胎週数, 向精神薬の種類および数と新生児薬物,離脱スコア(以下離脱スコア)の関連について検討した. また従属変数を離脱スコア, 説明変数を性別, 出生体重, ,抗うつ薬, 睡眠薬, 抗精神病薬のそれぞれの数として線形回帰分析を施行した. 対象は82例で, 内服薬は抗精神,病薬が50例, 睡眠薬が39例, 抗うつ薬が38例, 抗不安薬が34例であった. 離脱スコアの中央値は1点で最低は,0, 最大は9点であった. 性別による離脱スコアの有意な差は認めず, 離脱スコアと母体内服薬剤数の有意な相関,は認めなかった. 離脱スコアは睡眠薬の数と有意な正の相関を認めた. 複数の睡眠薬を内服している母から出生し,た児では特に注意深い観察を要することが示された. |
| Practice | 臨床医学：内科系 |
| Keywords | neonatal abstinence syndrome, abstinence score, sleep medications, antidepressant, antipsychotic drugs |
English
| Title | Which Maternal Psychotropic Agents Affect the Neonatal Abstinence Score in Neonates Born to Mothers Who Use Psychotropic Medicine? |
|---|---|
| Subtitle | |
| Authors | Kurita NAKAYAMA*1*2, Takeshi UTSUNOMIYA*1, Yoshihisa MASUDA*1, Ayumi NAKATA*1, Maiko MISAKI*1, Tsubasa KOUDA*1, Akio SHIBATA*1, Hitomi SEINO*3, Masumi OKUDA*1, Hisato MATSUNAGA*3, Hiroaki SHIBAHARA*4, Yasuhiro TAKESHIMA*1 |
| Authors (kana) | |
| Organization | *1Department of Pediatrics, Hyogo College of Medicine, *2Department of Pediatrics and Neonatology, Toyooka Hospital, *3Department of Neuropsychiatry, Hyogo College of Medicine, *4Department of Obstetrics and Gynecology, Hyogo College of Medicine |
| Journal | Journal of Japan Society for Neonatal Health and Development |
| Volume | 33 |
| Number | 3 |
| Page | 567-573 |
| Year/Month | 2021 / 10 |
| Article | Original article |
| Publisher | Japan Society for Neonatal Health and Development |
| Abstract | [Introduction] Neonatal abstinence syndrome may occur in neonates born to mothers who use psychotropic medicine. Our purpose was to determine which maternal psychotropic medications are associated with neonatal abstinence scores. [Methods] We performed a retrospective study on neonates born to mothers who were undergoing treatment with at least one psychotropic medicine and were admitted to Hyogo College of Medicine Hospital from 2016 to 2019. First, we investigated the association between the neonatal abstinence score and variables including sex, birth weight, gestational week, and the number of medications. Next, we performed linear regression analysis using the neonatal abstinence score as the outcome and the number of sleep medications, antipsychotics, antidepressants, offspring birth weight, and sex as independent variables. [Results] The subjects were 82 neonates. The results showed that the mothers used antipsychotics (n=50) most frequently, followed by sleep agents (n=39), antidepressants (n=38), and anxiolytics (n=34). The median value of neonatal abstinence score was 1. The maximum and minimum value of neonatal abstinence score was 9 and 0, respectively. There was no difference between males and females in the neonatal abstinence scores, and there was no correlation between the neonatal abstinence score and gestational week, birth weight, or the number of maternal psychotropic medicines used. Our findings revealed that neonatal abstinence score was significantly associated with the number of sleep agents that the mother used (p=0.01). [Conclusion] Healthcare providers should carefully observe neonates born to mothers using sleep medications. |
| Practice | Clinical internal medicine |
| Keywords | neonatal abstinence syndrome, abstinence score, sleep medications, antidepressant, antipsychotic drugs |
- 全文ダウンロード： 従量制、基本料金制の方共に770円(税込) です。
参考文献
- 1) Stephansson O, Kieler H, Haglund B, et al. Selective serotonin reuptake inhibitors during pregnancy and risk of stillbirth and infant mortality. JAMA 2013; 309: 48-54.
- 2) Kieviet N, Dolman KM, Honig A. The use of psychotropic medication during pregnancy: how about the newborn? Neuropsychiatr Dis Treat 2013; 9: 1257-1266.
- 3) 厚生労働省医政局地域医療計画課. 合併症を有する妊娠と周産期医療体制. https://www.mhlw.go.jp/file/05-Shingikai-10801000-Iseikyoku-Soumuka/0000134646.pdf (参照2020.11.04)
- 4) ACOG Committee on Practice Bulletins--Obstetrics. ACOG Practice Bulletin: Clinical management guidelines for obstetrician-gynecologists number 92, April 2008 (replaces practice bulletin number 87, November 2007). Use of psychiatric medications during pregnancy and lactation. Obstet Gynecol 2008; 111: 1001-1020.
- 5) Finnegan LP, Connaughton JF Jr, Kron RE, et al. Neonatal abstinence syndrome: assessment and management. Addict Dis 1975; 2: 141-158.
残りの16件を表示する
- 6) Lipsitz PJ. A proposed narcotic withdrawal score for use with newborn infants. A pragmatic evaluation of its efficacy. Clin Pediatr(Phila) 1975; 14: 592-594.
- 7) 磯部健一, 河田 興, 日下 隆他. 新生児離脱症候群の管理と薬物代謝; 抗痙攣剤と向精神薬. 周産期シンポ 1996; 14: 65-75.
- 8) 辻本美沙, 宮原史子, 奈良井 哲他. 当院で経験した向精神薬内服母体から出生した児の検討. 日周産期・新生児会誌 2018; 54: 1024-1029.
- 9) 厚生労働省. 重篤副作用疾患別対応マニュアル 新生児薬物離脱症候群. 2010. https://www.mhlw.go.jp/topics/2006/11/dl/tp1122-1j17.pdf (参照2020.11.15)
- 10) 日下田大輔, 亀田高志, 山崎 優他. 当院での精神疾患合併妊娠の検討. 日周産期・新生児会誌 2018; 54: 46-50.
- 11) Swortfiguer D, Cissoko H, Giraudeau B, et al. Neonatal consequences of benzodiazepines used during the last month of pregnancy. Arch Pediatr 2005; 12: 1327-1331.
- 12) Charles MK, Cooper WO, Jansson LM, et al. Male Sex Associated with Increased Risk of Neonatal Abstinence Syndrome. Hosp Pediatr 2017; 7: 328-334.
- 13) Unger A, Jagsch R, Bawert A, et al. Are male neonates more vulnerable to neonatal abstinence syndrome than female neonates? Gend Med 2011; 8: 355-364.
- 14) Hou Y, Tan Y, Belcheva MM, et al. Differential effects on gestational buprenorphine, naloxone, and methadone on mesolimbic mu opioid and ORL1 receptor G protein coupling. Brain Res Dev Brain Res 2004; 151: 149-157.
- 15) Doberczak TM, Kandall SR, Wilets I. Neonatal opiate abstinence syndrome in term and preterm infants. J Pediatr 1991; 118: 933-937.
- 16) Dysart K, Hsieh HC, Kaltenbach K, et al. Sequela of preterm versus term infants born to mothers on a methadone maintenance program: differential course of neonatal abstinence syndrome. J Perinat Med 2007; 35: 344-346.
- 17) Ruwanpathirana R, Abdel-Latif ME, Burns L, et al. Prematurity reduces the severity and need for treatment of neonatal abstinence syndrome. Acta Paediatr 2015; 104: e188-e194.
- 18) Kaltenbach K, Holbrook AM, Coyle MG, et al. Predicting treatment for neonatal abstinence syndrome in infants born to women maintained on opioid agonist medication. Addiction 2012; 107 Suppl 1: 45-52.
- 19) Pond SM, Kreek MJ, Tong TG, et al. Altered methadone pharmacokinetics in methadone-maintained pregnant woman. J Pharmacol Exp Ther 1985; 233: 1-6.
- 20) Gentile S. On categorizing gestational, birth, and neonatal complications following late pregnancy exposure to anti-depressants: the prenatal antidepressant exposure syndrome. CNS Spectr 2010; 15: 167-185.
- 21) 伊藤 進, 小谷野 薫, 小谷野耕佑. 臓器・系統別副作用各論 -重大な副作用を中心に- 精神 新生児薬物離脱症候群. 日臨 2019; 77: 431-436.
