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جستجوی مقالات مرتبط با کلیدواژه « Neonatal Abstinence Syndrome » در نشریات گروه « پزشکی »

  • نیلوفر حاجی عراقی، مریم موسوی*
    زمینه و هدف

    در دهه اخیر، مصرف مواد مخدر در بارداری و به دنبال آن تولد نوزادان مبتلا به سندروم محرومیت از مواد (neonatal abstinence syndrome (NAS)) افزایش یافته که هزینه‏های مراقبتی را بالا برده است. امروزه بر روش‏های غیردارویی مانند شیردهی، جهت کاهش علایم NAS تاکید می‏شود. بنابراین هدف از این مطالعه، بررسی تاثیر شیردهی مادران وابسته به مصرف مواد مخدر(اوپیوییدها) بر سندروم محرومیت نوزاد بود.

    روش کار

    این مطالعه، یک پژوهش مروری، با جستجو در پایگاه‏های Google Scholar، Science Direct، Pub Med، Medline، SID، Magi ran، و کلید واژه‏های“Breastfeeding” “opioids” “mothers” neonatal abstinence syndrome (NAS)” “Drug Abuse/Parenteral”“، در طی سال‏های2020-2010، است. در نهایت 24 مطالعه انتخاب، و داده ها ارزشیابی و تحلیل شد.

    یافته‏ ها

     میزان شیردهی در مادران وابسته به مواد مخدر بسیار پایین بود، در حالی که شیردهی در مادران وابسته به اوپیوییدها یا تحت درمان با این داروها، ایمن در نظر گرفته می‏شود. شیردهی، باعث کاهش طول مدت و شدت علایم NAS، طول مدت بستری، دارو درمانی، هزینه‏های مراقبتی، سندروم مرگ ناگهانی و ایجاد پیوند عاطفی مادر و نوزاد و سازگاری مادر با بی‏قراری حاصل از NAS می‏شود.

    نتیجه ‏گیری

     با توجه به تاثیر شیردهی مادران وابسته به اوپیوییدها یا تحت درمان با این داروها در کاهش علایم NAS توصیه می‏شود، کادر درمان با شناسایی، برداشتن موانع و حمایت روانی این مادران بر اهمیت شیردهی به عنوان یک روش ایمن، ارزان و موثر تاکید کنند. با این وجود، به علت مطالعات محدود در کشور ایران، پژوهش‏های گسترده‏تری در این زمینه لازم است.

    کلید واژگان: شیردهی, سندروم محرومیت نوزاد, مادران, سوء مصرف مواد, وریدی, اوپیوئیدها}
    Niloofar Hajiaraghi, Seyed Maryam Mousavi*
    Background & Aims

     Breastfeeding is the safest and the best way to provide growth and development of newborn and protect against many diseases. breast feeding is known to be beneficial for many benefits such as reduction of neonatal death syndrome) Sudden Infant death syndrome-SIDS (childhood and postpartum depression are a major public health strategy. these benefits may be particularly important for families who are grappling with drug use. while the use of addictive substances is a global health problem and dependence on drugs causes a certain concern. because this affects maternal, fetal and newborn health. during the past decade, drug use has grown dramatically and now become a major public health problem. drug abuse during pregnancy has led to an increase in the birth rate of a number of children with the syndrome of substance (neonatal abstinence syndrome-NAS (. the cost of health care has skyrocketed. sudden cessation of drugs in newborns from mothers of drug users on the following days of birth leads to baby deprivation syndrome with symptoms such as tachycardia, tremor, agitation, increased tone, convulsions, nutrition and poor nutrition, vomiting, diarrhea, sweating, fever and nausea. in addition, the time of hospitalization of newborns with NAS in hospital was 16.4 days compared to other children who were 3.3 days. there are also 46 - 76 % of the probability that these babies undergo drug therapy, such as the treatment cost, whereas drug addicts have low economic status.  recent studies have shown that non - pharmacological agents should be used as the first line of treatment to reduce symptoms of NAS. among the non - pharmacological methods, breastfeeding may result in reduced severity and severity of symptoms. in addition, studies show a direct relationship between breastfeeding and decrease in length of admission, decrease of symptoms and necessity of drug interventions in NAS. the American academy of pediatrics and the world health organization, have a strong emphasis on breastfeeding for the first 6 months of life. In this regard, this study was conducted with the aim of investigating the effect of breastfeeding in mother's dependent on the use of narcotic drugs (opioids) on infant deprivation syndrome.

    Methods

    The present article is a review study that researchers in Google Scholar, Science Direct, Pub Med, Medline, SID, Magi ran, using keywords Breastfeeding [mesh]", "opioids[mesh]", "neonatal abstinence syndrome (NAS) [mesh]” and “mothers [mesh]” “Drug Abuse/Parenteral [mesh]” and searched for 10 years between 2010-2020. inclusion criteria in this study were qualitative and quantitative studies on the effect of breast feeding on deprivation syndrome, in domestic and domestic practical journals, focusing on benefits and usefulness, descriptive and investigative and review, access to full text and English and Persian language articles were considered. and unrelated, repetitive, language having different language and weak relation with the goal of study, and without proper executive methods, were excluded. in the search phase of the texts, some studies were carried out based on inclusion criteria. then, the remaining studies were evaluated and analyzed in terms of content. the initial search result of 876 studies, which 48 studies, due to having a different language, 775 studies, after reviewing title and purpose , respectively 16 after reviewing the summary, 15 studies were deleted after reviewing the text and two studies were added as a result of manual search. in the end, 24 studies were included. after the evaluation of these studies, the data were analyzed through comparison, summing up and determining the validity. it should be noted that regarding the wide distribution of mothers ' breastfeeding in this article, it is necessary to review the effect of breast feeding on pain syndrome of newborn.

    Results

    According to studies, mothers who struggle with addiction are one of the most vulnerable groups among mothers. the amount of breastfeeding in these cases is very low. according to the results of the study, the socioeconomic status, age, education, social influence, knowledge and knowledge of breastfeeding, the health and mental health status of the mothers of the opioid - dependent mothers, support and pre - natal education influence the decision to breastfeed. in a study conducted (Wachman et al (colleagues on the extent of breastfeeding among the dependent mothers, the results indicated that only a small number of mothers of breast - feeding infants fed their infants. more than half of those, after a week of breast feeding, stopped feeding their baby and did not feed their baby at all. the results of the present study were shown by Volstrand et al. Breastfeeding rates were high in mothers treated with opioids (methadone and buprenorphine), but early cessation of breastfeeding is common among them. however, the effect of opioids on opioids is not considered safe, since opioids are considered to be immune to opioids as a result of opioids consumption in the mother, its secretion in milk is low and there is no risk for baby. according to the results of the study, breastfeeding can help to create an emotional bond between mother and baby, especially in addicted mothers with opioids, breastfeeding increases the release of oxytocin hormone, which has calm effects on mother. perhaps one of its benefits is the help of mother 's adaptation with agitation from NAS in the infant and reduce the likelihood of getting the baby by these mothers. also, breast feeding leads to decrease in severity of symptoms such as severity of symptoms, duration of stay in hospital, need for drug delivery and decrease of care costs. in addition, breastfeeding in these mothers reduced incidence and duration of neonatal signs symptoms in newborns. breastfeeding also has a positive effect on the prevention of sudden infant mortality (SID). therefore, it is recommended to be conducted on children at risk such as newborns with opioids in the uterus of breast feeding. the results of this study showed that the need for drug for treatment of deprivation syndrome in neonates fed by breastfeeding mothers was higher than newborns who had not been fed with breast milk. most of these neonates had normal weight and had better weight gain. also, according to the research, exclusive breast feeding was more effective in reducing the symptoms of breast feeding with breast milk, compared to breast feeding, or a combination of breast milk and formula. previous studies in 2012 - 2016 showed that compared to breastfed infants in 2012 - 2016, breastfeeding in mother's dependent to opioids leads to shortening the length of stay of newborns with NAS in hospital. although the study showed that breastfeeding reduced the duration of hospitalization and decreased the need for treatment of NAS, but in a research it was stated that the need for treatment for newborns with NAS and the other group that were fed with milk had been fed. there was no significant difference in this study suggesting that breast - feeding practice is more important than milk pharmaceutical content and more research should be done in this regard. therefore, it is suggested that opioids are dependent on opioids use to help their children if NAS occur, unless the hazards are greater than the benefits. according to the studies, clinicians have played a very important role in understanding, supporting, consulting and defending mothers ' rights that they wish to feed their children with the syndrome of food deprivation, and to inform them of the complications of drug use on their babies before the full cessation of breastfeeding. they also need to be encouraged to not consume alcohol, cigarettes or other illegal drugs throughout the lactation and receive mental support and medication from health centers and health care providers.

    Conclusion

    The World Health Organization recommends methadone and buprenorphine in substance use treatment for all individuals, especially in women during pregnancy and lactation, along with psychotherapy. in the case of reducing the rate of symptoms in the infant, mothers who were treated with methadone (74 %) or buprenorphine (78 %) had no difference after delivery to their infants. in the study of johnson et al., the amount of methadone released in breast milk is -21-462 ng / ml, and it is unlikely to have a trace amount of methadone that is transmitted through the breast milk. therefore, the infants of methadone and Buprenorphine mothers can be fed by mother 's milk and can be used as a beneficial benefit. in addition, mothers can also use a good mother 's sense of breastfeeding as an opportunity to change their course of life. although some mothers of breast - feeding are challenging to their newborn, because the vibration, weak muscle tone, bound movements and poor swallowing will cause problems in breast and breast feeding. on the other hand, the approach and the frustrations of health care givers were not effective in breast feeding. therefore, understanding the benefits of breastfeeding depends on the use of opioids in reducing infant Deprivation to treatment staff to recommend breast feeding to these high - risk mothers. in addition, successful breastfeeding in these mothers requires nurses " education, understanding psychological problems , creating a secure environment, observing privacy and physical and mental protection by health care providers and eliminate the barriers to breastfeeding.

    Keywords: Breastfeeding, Neonatal abstinence syndrome, Mothers, Drug Abuse, Parenteral, Opioids}
  • Gholamreza Faal *, Sepide Hajmohammadi
    Background
    Since there is insufficient data to compare the relative efficacy of commonly prescribed opioids (morphine and buprenorphine), the present study aimed to compare the effect of morphine and buprenorphine on term and near-term neonates with neonatal abstinence syndrome.
    Methods
    This double-blind randomized clinical trial was performed on 60 neonates whose mothers were addicted to drugs (opium and its derivatives) and the neonate had symptoms of withdrawal syndrome. They were all. Admitted to Valiasr Hospital in Birjand. Neonatal assessment was based on Finnegan score. The neonates were randomly assigned in two groups of buprenorphine (n = 30) and morphine (n = 30). The Chi square test, Fisher exact test, student t test and Mann-Whitney U test were used for comparing the background characteristics and treatment outcomes between the two groups.
    Results
    In the present study, a total of 53.3% of the patients in both groups were boys and the rest were girls. The mean lengths of hospital stay in the buprenorphine and morphine groups were 5.97 ± 3.38 and 7.53 ± 4.83 days, respectively (p=0.15). Also, apnea was observed in 33.3% of the total neonates in the buprenorphine group and 43.3% of the neonates in the morphine group (p=0.43). The two groups were homogenous in regards to apnea complications, oral intolerance, hypotension and blood culture result (p>0.05)
    Conclusion
    The results of the present study showed no significant difference in the outcomes of treatment and reduction of treatment complications between the buprenorphine and morphine-treated neonates.
    Keywords: Neonatal Abstinence Syndrome, Morphine, Buprenorphine}
  • Mohammad Radgoodarzi, Elahe Norouzi, Zahra Vahedi, Mitra Salavati, Ameneh Yaghoubi, Reza Behmadi *
    Background

     Congenital heart defects (CHDs) are the most common congenital malformations at birth. Substance abuse has increased dramatically over the past two decades. It also can affect neonates of drug-abusing mothers.

    Objectives

     This study aimed to elucidate the possible association of maternal drug abuse with CHDs in their newborn infants.

    Patients and Methods

     In this study, 72 neonates who were born during 6 years in three teaching hospitals are studied. Echocardiography was performed by a single pediatric cardiologist using two-dimensional and color Doppler echocardiography. The data were analyzed using descriptive statistics.

    Results

     1) Of 72 included cases, 38 (52.78%) had abnormal echocardiographic findings; 2) from 38 abnormal echocardiography, 35 (48.61% of total and 92.11% of abnormal echoes) had mild congenital heart defect (CHD), and 3 had complex CHD; 3) There was no significant difference in the prevalence of neonatal congenital heart defect with the type of misused drugs (opiates or methamphetamines).

    Conclusions

     In our study, the prevalence of CHD in newborns of drug abuser mothers was significantly higher than the normal population of infants. Hence, echocardiographic screening of these newborns seems to be logical.

    Keywords: Echocardiography, Congenital Heart Defects, Neonatal Abstinence Syndrome}
  • Fereshteh Sadeghi, Monir Ramezani, Nayere Kargarkakhki*, Gholam Hosein Zarifnejhad
    Objectives

    The prevalence of drug abuse among pregnant women is increasing worldwide, putting their infants at the risk of many disorders. Neonatal abstinence syndrome (NAS) is considered as a neurological disorder in infants who are exposed to narcotics during pregnancy. Breastfeeding is implicated to markedly reduce the incidence and severity of the NAS, as well as the need for therapeutic agents. Therefore, the present study aimed to investigate the duration of exclusive breastfeeding and the hospital stay of infants with NAS, as well as the challenges ahead and solutions to extend the lactation period in drug-addicted mothers.

    Methods

    A number of review articles indexed in PubMed, Google Scholar, and Medline databases were scrutinized in this study. The chosen review articles surveyed experimental/quasi-experimental studies that were published during 2004-2018 using keywords including NAS, drug-addicted mothers, exclusive breastfeeding barriers, and continued breastfeeding.

    Results

    According to the results, the duration of continued breastfeeding in drug-addicted women was short and it failed in the first six months after delivery. The critical factors interfering with continued breastfeeding were categorized into individual, family, and social barriers. In addition, social barriers consisted of fear and misconception about lactation, the lack of awareness and motivation, along with the lack of family support and health care centers. The findings suggest that mother’s training during the pregnancy, mother-infant rooming-in, and mother-infant skin-to-skin contact could be potentially applied to extend the duration of the lactation in drug-addicted pregnant women.

    Conclusions

    In general, hospitals should provide a comfortable environment to encourage drug-addicted women to breastfeed infants with the NAS. It seems that providing resources and facilities where drug-addicted women could discuss barriers to breastfeeding, as well as gaining access to lactation counselors and other professional practitioners would help mothers to continue breastfeeding.

    Keywords: Neonatal abstinence syndrome, Drug-addicted mothers, Exclusive breastfeeding, Continued breastfeeding, Breastfeeding barrier}
  • Sara Ghahremani, Farideh Asadzadeh, Forough Rakhshanizadeh, Sepideh Fanaei, Iman Hashemi Petroudi, Faezeh Ghorbani, Masumeh Ghazanfarpour *, Zeinab Sadat Hoseini
    Background
    The Neonatal Abstinence Syndrome (NAS) has been treated so far by various drugs, such as opioids and non-opioids. There is some concern about NAS babies who receive chemical drug treatment. Some researchers mentioned that shorter pharmacological treatment and less lengthy hospitalization are associated with several secondary advantages. The aim of this study was to assess safety, tolerability, and efficacy of acupuncture in management of Neonatal Abstinence Syndrome in infants.  
    Materials and Methods
    An extensive search was done in databases of Medline, EMBASE, Scopus, Cochrane, and Web of Science until August 2018. Two independent researchers screened articles, in the next step, full texts of probably relevant articles were summarized and categorized based on the evaluated outcomes and overall effect size was presented.
    Results
    Five studies were included in the systematic review. Auricular acupuncture when implemented as adjunct pulse non pharmacologic in management of NAS is safe, feasible, and acceptable. However, Auricular acupressure did not show any significant effect on pharmacological therapy, length of hospital stay and average NAS scores. Treatment with Laser acupuncture as adjunct in management of infants with NAS were associated with several advantages. These include improvement in feeling (better relaxation and higher calorie intake), decreased Finnegan scores, shorter duration of treatment with morphine, and shorter duration of hospitalization. In terms of safety, treatment with laser acupuncture as adjunctive were well-tolerated.
    Conclusion
    The findings of this systematic review showed that infants with NAS secondary to maternal opiate usage may receive more benefits of treatment with acupuncture in combination with pharmacologic therapy compared to pharmacologic therapy alone. In these findings should be interpreted in light of mentioned limitation.
    Keywords: Acupuncture, Acupressure, Efficacy, Neonatal Abstinence Syndrome}
نکته
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