Neonatales Abstinenzsyndrom bei europäischen und nordamerikani­schen Neugeborenen: Unterschiede im klinischen Verlauf an Hand von Daten einer prospektiven randomisierten Studie

Abstract

In addition to intrauterine medication exposure other aspects such as different addiction severity of the mothers, different treatment modalities including rooming-in as well as the frequency of NAS ratings may be influencing the course of NAS.

Rural, Pregnant, and Opioid Dependent: A Systematic Review

“…[21][22][23][24] Overall, rural women participating in the MOTHER trial were more likely to be younger, employed, White, and have a planned pregnancy compared to urban women. [21][22][23][24] Rural women were also more likely to volunteer for the study, and, if enrolled in the study, they were more likely to be retained in the study. 21,23 Furthermore, rural women often required lower doses of methadone or buprenorphine to manage their symptoms.…”

“…[21][22][23][24] Rural women were also more likely to volunteer for the study, and, if enrolled in the study, they were more likely to be retained in the study. 21,23 Furthermore, rural women often required lower doses of methadone or buprenorphine to manage their symptoms. 24 Finally, infants had lower rates of treatment for NAS and also had shorter hospital stays for NAS.…”

“…24 Finally, infants had lower rates of treatment for NAS and also had shorter hospital stays for NAS. 23,24 The study authors note that, although a standard protocol was used at all sites in the MOTHER trial, local variation did exist in terms of both screening methods and treatment protocols, which may lead to biased results. Three observational studies were identified that compared urban and rural, substance-using pregnant women in terms of birth outcomes, 25 patterns of substance use, 20,26 and utilization of treatment services.…”

“…19,24 This difference is attributed to the relatively younger age of rural, opioidusing pregnant women, the use of prescription opioids rather than heroin, and possibly stabilizing factors such as employment and marriage, which are implied as surrogates for less severe opioid use. [21][22][23][24] However, changing patterns of opioid use and routes of administration are now being observed in rural pregnant women, [28][29][30] and these changes follow trends observed in the rural population more generally. Recent federal drug policy changes in the United States and Canada have limited the availability of the most frequently abused prescription opioid and may have indirectly contributed to emerging heroin and intravenous drug use in rural areas.…”

“…Most rural pregnant women smoke cigarettes in addition to using opioids and to a lesser extent use marijuana, benzodiazepines, or cocaine. 14,15,[19][20][21][22][23][24][25][26][27][28][29][30][31] The discussion on polysubstance use was largely descriptive, with no articles addressing treatment.…”