アブストラクト
Japanese
| Title | 新生児薬物離脱症候群 |
|---|---|
| Subtitle | 総説 |
| Authors | 平野慎也 |
| Authors (kana) | |
| Organization | 大阪母子医療センター 新生児科 |
| Journal | 大阪母子医療センター雑誌 |
| Volume | 33 |
| Number | 1/2 |
| Page | 8-13 |
| Year/Month | 2017 / |
| Article | 報告 |
| Publisher | 大阪母子医療センター |
| Abstract | 「要約」新生児薬物離脱症候群は, 胎児へと移行していた薬物が突然, 出産を機に新生児から消失していく過程でさまざまな症状を来す症候群である. 代表的な原因薬物はオピオイド系薬物であるが, 我が国ではオピオイドの使用は少なく, むしろ最近では, 母体の原疾患の治療目的で服用している抗精神病薬, 抗うつ薬, 催眠鎮静薬, 抗不安薬, 抗てんかん薬などの非オピオイド系の薬物によるものがほとんどである. 正確な発生頻度は不明であるが近年治療を要する母体精神疾患の増加につれて増えている. 新生児薬物離脱症候群の管理においてはfinneganスコアや磯部らのスコアが用いられ, モニタリングや治療の開始, 中止の判断には有用である. 治療の原則は母児関係を重視して, 適切に環境に適応させることにおかれる. 新生児薬物離脱症候群を発症した児の長期予後については不明な部分も多く今後の症例の蓄積が待たれる. |
| Practice | 医学総合 |
| Keywords | 新生児薬物離脱症候群, オピオイド, 抗精神薬, Finneganスコア, Neonatal abstinence syndrome, neonatal withdrawal syndrome, opioids, antidepressant, Finnegan score |
English
| Title | Neonatal abstinence syndrome |
|---|---|
| Subtitle | |
| Authors | Shinya Hirano |
| Authors (kana) | |
| Organization | Department of Neonatal Medicine |
| Journal | Journal of Osaka Women's and Children's Hospital |
| Volume | 33 |
| Number | 1/2 |
| Page | 8-13 |
| Year/Month | 2017 / |
| Article | Report |
| Publisher | Osaka Women's and Children's Hospital |
| Abstract | [Abstract] Neonatal abstinence syndrome (Neonatal withdrawal syndrome) is a result of the sudden discontinuation of fetal exposure to substances that were used by the mother during pregnancy. The most common substances are opioids, but non-opioids that are used to treat diseases of mothers are predominant in Japan. The exact incidence of neonatal abstinence syndrome (NAS) is not known, but it has increased markedly. NAS leads to a variety of signs and symptoms involving multiple systems. The pathophysiology of NAS is not completely understood. To assess the severity of and manage NAS, the Finnegan scoring system and/or Isobe's assessment system is commonly used. The systems are helpful for initiating, monitoring, and terminating treatment. What should be emphasized in management is to provide care with the recognition of the importance of the infant-mother dyad. Regarding the long-term effects of NAS on children after prenatal exposure, future studies are required. |
| Practice | General medicine |
| Keywords | Neonatal abstinence syndrome, neonatal withdrawal syndrome, opioids, antidepressant, Finnegan score |
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参考文献
- 1) 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 平成22年3月 厚生労働省
- 2) Patrick SW, Schumacher RE, Benneyworth BD, Krans EE, McAllister JM, Davis MM. Neonatal abstinence syndrome and associated health care expenditures:United States 2000-2009.JAMA.2012;307:1934-40.
- 3) Napolitano A, Theophilopoulos D, Seng SK, Calhoun DA. Pharmacologic management of neonatal abstinence syndrome in a community hospital. Clin Obstet Gynecol. 2013;56:193-201.
- 4) O'Donnell M, Nassar N, Leonard H, et al. Increasing prevalence of neonatal withdrawal syndrome:population study of maternal factors and child protection involvement. Pediatrics. 2009;123:e614-e621.
- 5) Levinson-Castiel R, Merlob P, Linder N, Sirota L, Klinger G. Neonatal abstinence syndrome after in utero exposure to selective serotonin reuptake inhibitors in term infants. Arch Pediatr Adolesc Med. 2006;160:173-6.
残りの20件を表示する
- 6) 磯部健一,石井真美,日下 隆,薬物内服中の母親から出生した新生児の管理の現状 厚生省心身障害研究「ハイリスク児の総合的ケアシステムに関する研究」平成6年研究報告書;1995:60.
- 7) Hudak ML, Tan RC. Committee on Drugs, Committee on Fetus and Newborn. Neonatal drug withdrawal. Pediatrics. 2012;129:e540-60.
- 8) Herzlinger RA, Kandall SR, Vaughan HG Jr. Neonatal seizures associated with narcotic withdrawal. J Pediatr. 1977;91:638-41.
- 9) van Baar AL, Fleury P, Soepatmi S, Ultee CA, Wesselman PJ. Neonatal behavior after drug dependent pregnancy. Arch Dis Child. 1989;64:235-40.
- 10) Pinto F, Torrioli MG, Casella G, Tempesta E, Fundaro C. Sleep in babies born to chronically heroin addicted mothers. A follow up study. Drug Alcohol Depend. 1988;21:43-7.
- 11) Liu AJ, Sithamparanathan S, Jones MP, Cook CM, Nanan R. Growth restriction in pregnan-cies of opioid-dependent mothers. Arch Dis Child Fetal Neonatal Ed. 2010 Jul;95:F258-62.
- 12) Prabhakar Kocherlakota. Neonatal Abstinence Syndrome. Pediatrics. 2014;134:e547-e561.
- 13) Wachman EM, Hayes MJ, Brown MS, et al. Association of OPRM1 and COMT single-nucleotide polymorphisms with hospital length of stay and treatment of neonatal abstinence syndrome. JAMA. 2013;309:1821-7.
- 14) Mague SD, Blendy JA. OPRM1 SNP(A118G):involvement in disease development, treatment response, and animal models. Drug Alcohol Depend. 2010;108(3):172-82.
- 15) Wachman EM, Hayes MJ, Lester BM, et al. Epigenetic variation in the mu-opioid receptor gene in infants with neonatal abstinence syn-drome. J Pediatr. 2014;165:472.
- 16) Finnegan LP, Connaughton JF Jr, Kron RE, Emich JP. Neonatal abstinence syndrome:assessment and management. Addict Dis 1975;2:141-158.
- 17) Lipsitz PJ:A proposed narcotic withdrawal score for use with newborn infants. A prag-matic evaluation of its efficacy. Clin Pediatr. 1975;14:592-594.
- 18) 磯部健一,河田 興,日下 隆,石井真美,伊藤 進,大西鐘壽他: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.周産期学シンポジウム 1996;14:65-75.
- 19) Doberczak TM, Kandall SR, Wilets I. Neonatal opiate abstinence syndrome in term and preterm infants. J Pediatr. 1991;118:933-7.
- 20) Dysart K, Hsieh HC, Kaltenbach K, Greenspan JS. Sequela of preterm versus term infants born to mothers on a methadone maintenance program:differential course of neonatal absti-nence syndrome. J Perinat Med. 2007;35:344-6.
- 21) Jansson LM, Choo R, Velez ML, et al. Methatone maintenance and breastfeeding in the neonatal period. Pediatrics, 2008;121:106-114
- 22) Hunt RW, Tzioumi D, Collins E, Jeffery HE. Adverse neurodevelopmental outcome of infants exposed to opiate in utero. Early Hum Dev. 2008;84:29-35,
- 23) Klinger G, Frankenthal D, Merlob P, et al. Long-term outcome following selective serotonin reuptake inhibitor induced neonatal abstinence syndrome. J Perinatol. 2011;31:615-20
- 24) Hviid A, Melbye M, Pasternak B. Use of selec-tive serotonin reuptake inhibitors during Preg-nancy and risk of autism. N Engl J Med. 2013;369:2406-2415
- 25) Behnke M, Smith VC. Prenatal substance abuse:short-and long-term effects on the ex-posed fetus;Committee on Substance Abuse;Committee on Fetus and Newborn. Pediatrics. 2013;131:e1009-24.
