N ÖZDEMİROĞLU, S. KARA, C.C. KURT, F İ ARIKAN, Y. BİLGE DALLAR

Neonatal yoksunluk sendromu olan prematüre bebek

Neonatal yoksunluk sendromu (NYS) prenatal bağımlılık yapan maddelere maruziyet sonrası çekilme semptomlarıyla ve fiziksel bağımlılıkla karakterize klinik bir durumdur. Opioid dışındaki tüm ilaç sınıfları için bu belirtiler genellikle kendi kendini sınırlar ve farmakolojik tedavi gerektirmez. Gelişmiş ülkelerde hamile kadınların %4.4'ü yasadışı ilaç kullanmaktadır. Gebelik boyunca eroine maruziyet prematürite, açıklanamayan intrauterin gelişme geriliği, plasenta yetmezliği, doğum sonrası kanama, preeklampsi ve erken membran rüptürü de dahil olmak üzere fetal ölüm ve neonatal morbidite ile ilişkilidir. Ülkemizde neonatal yoksunluk sendromu ile doğan bebeklerle ilgili oldukça sınırlı sayıda olgu sunumu yapılmıştır.

Premature infant with neonatal abstinence syndrome

Neonatal abstinence syndrome (NYS) is a clinical condition characterized by physical dependence and withdrawal symptoms after prenatal exposure to addictive substances. These symptoms are self-limiting and usually do not require pharmacological treatment for all classes of drugs, except for opioids. In developed countries 4.4 % of pregnant women use illegal drugs. Heroin exposure during pregnancy causes prematurity, unexplained intrauterine growth restriction, placental insufficiency, postpartum hemorrhage, including pre-eclampsia and premature rupture of membranes which is associated with fetal death and neonatal morbidity. In our country, there are a very limited number of case reports about babies born with neonatal abstinence syndrome.

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1. Schneck H. Narcotic withdrawal symptoms in the newborn infant resulting from maternal addiction. J Pediatr 1958;52(5):584-7.
2. Dikshit S.K. Narcotic withdrawal syndrome in newborns. Indian J Pediatr 1961;28(1):11-5.
3. Sherwood RA, Keating J, Kavvadia V, Greenough A, Peters TJ. Substance misuse in early pregnancy and relationship to fetal outcome. Eur J Pediatr 1999;158(6):488-92.
4. Merikangas KR, McClair VL. Epidemiology of substance use disorders. Hum Genet 2012;131(6):779-89.
5. Finnegan LP, Kandall SR, In Lowinson JH, Ruiz P, Millman RB. (eds): Maternal and Neonatal Effects of Alcohol and Drugs. Philadelphia: Lippincott Williams & Wilkins; 2005:805-39.
6. Kennare R, Heard A, Chan A. Substance use during pregnancy: Risk factors and obstetric and perinatal outcomes in South Australia. Aust N Z J Obstet Gynaecol 2005;45(3):220-5.
7. Behnke M, Eyler FD. The consequences of prenatal substance use for the developing fetus, newborn and young child. Int J Addict 1993;28(13):1341-91.
8. Hudak ML, Tan RC, Committee on Drugs, et al. Neonatal drug withdrawal. Pediatrics 2012;129(2):e540-60.
9. Schuckit MA. Opioid druge abuse and dependence. In: Fauci AS, Braunwald E, Kasper DL, Hauser SL, Longo DL, Jameson JL, Loscalzo J (eds). Harrison's Principles of İnternal Medicine.17th ed, McGraw-Hill: New York; 2008:388-402.
10. Waldemar AC. Substance abuse and neonatal abstinence. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF (eds). Nelson Textbook Pediatrics. Philadelphia: Saunders Elsevier; 2012:623-5.
11. Kuschel C. Managing drug withdrawal in the newborn infant. Semin Fetal Neonatal Med 2007;12(2):127-33.
12. Zelson C, Rubio E, Wassermann E. Neonatal narcotic addiction: 10 year observation. Pediatrics 1971; 48(2):178-89.
13. Kandall SR, Gartner LM. Late presentation of drug withdrawal symptoms in newborns. Am J Dis Child 1974;127(1):58-61.
14. Herzlinger RA, Kandall SR, Vaughan HG Jr. Neonatal seizures associated with narcotic withdrawal. J Pediatr 1977;91(4):638- 41.
15. Van Baar AL, Fleury P, Soepatmi S, Ultee CA, Wesselman PJ. Neonatal behavior after drug dependent pregnancy. Arch Dis Child 1989;64(2):235-40.
16. Abdel-Latif ME, Pinner J, Clews S,Cooke F, Lui K, Oei J. Effects of breast milk on the severity and outcome of neonatal abstinence syndrome among infants of drug-dependent mothers. Pediatrics 2006;117(6):1163-9.
17. Bio LL, Siu A, Poon CY. Update on the pharmacologic management of neonatal abstinence syndrome. J Perinatol 2011;31(11):692-701.
18. Hunt RW, Tzioumi D, Collins E, Jeffery HE. Adverse neurodevelopmental outcome of infants exposed to opiate in-utero. Early Hum Dev 2008;84(1):29-35.
19. Can E, Bülbül A,Uslu S, Güran Ö, Nuhoğlu A. Neonatal yoksunluk sendromu. Şişli Etfal Hastanesi Tıp Bülteni 2010;44(2):124-1.
20. AAP Committee on Drugs. Neonatal drug withdrawal. Pediatr 1998;101(6):1079-88.
21. Finnegan LP, Kron RE, Connaughton JF, Emich JP. Assessment and treatment of abstinence in the infant of the drug- dependent mother. Int J Clin Pharmacol Biopharm 1975;12(1-2):19-32.
22. Sinha C, Ohadike P, Carrick P, Pairaudeau P, Armstrong D, Lindow SW. Neonatal outcome following maternal opiate use in late pregnancy. Int J Obstet Gynaecol 2001;74(3):241-6.