Araştırma Makalesi
Yıl 2019,
Cilt: 13 Sayı: 3, 171 - 176, 24.05.2019
Öz
Amaç: Neonatal yoksunluk sendromu (NYS) görülme oranı giderek artan, ciddi bir sorundur. Türkiye’de gebelerde
yasadışı uyuşturucu kullanımı ve NYS oranı bilinmemektedir. Nötrofil lenfosit oranı (NLO) ve diğer akut faz belirteçleri
sistemik inflamatuvar yanıtın göstergeleridir. Çalışmada NYS sıklığını ve NYS’ lu yenidoğanlarda akut faz belirteçleri ve
NLO değerlerinin ölçümünü amaçladık.
Gereç ve Yöntemler: Hastanemizde doğum yapan ve madde bağımlılığı saptanan annelerin bebekleri çalışmaya dâhil
edildi. Ciddi sarılığı olmayan fototerapi için yatırılan infantlar kontrol grubu olarak değerlendirildi. Finnegan skoru ile
NYS bulguları değerlendirildi. Çalışma grubu hastaların kanlarında hemogram, C- reaktif protein (CRP), interlökin-6 (IL)
düzeyleri ölçüldü. NLO ve diğer belirteçleri gruplar arasında karşılaştırıldı.
Bulgular: Neonatal yoksunluk sendromu olgularının sayısının 3989 yatan hastada 16 adet olduğu (4.01/1000) saptandı.
Hematolojik parametreler değerlendirildiğinde NLO değerlerinin NYS grubunda anlamlı derecede yüksek olduğu (p<0.05)
bulundu. Her iki grubun platelet indekslerine bakıldığında ortalama platelet volümünün (MPV) değerinin NYS grubunda
anlamlı derecede yüksek olduğu izlendi (p<0.05). Neonatal yoksunluk sendromu bulguları nedeniyle ilaç tedavisi alan
hastalarda NLO değerlerinin daha yüksek olduğu bulundu (p<0.05).
Sonuç: Neonatal yoksunluk sendromu ciddi morbidite ve mortaliteye neden olan ve giderek artan toplumsal bir
problemdir. Bu ilaçlara intrauterin maruziyet yenidoğanda inflamatuvar süreci tetiklemektedir. NLO ve MPV değerlerinin
NYS’lu infantlarda yüksek olması inflamasyonu göstermektedir.
Anahtar Kelimeler
Kaynakça
- 1. Kocherlakota P. Neonatal Abstinence Syndrome. Pediatrics 2014;134:e547–61.
- 2. Tolia VN, Patrick SW, Bennett MM. Increasing incidence of the neonatal abstinence syndrome in U.S. neonatal ICUs. N Engl J Med 2015; 372:2118-26.
- 3. Goler NC, Armstrong MA, Taillac CJ, Osejo VM. Substance abuse treatment linked with prenatal visits improves perinatal outcomes: A new standard. J Perinatol 2008; 28:597-603.
- 4. WHO. Guidelines for identification and management of substance use and substance use disorders in pregnancy World Health Organization. 2014:224.
- 5. Weaver MF. Perinatal addiction. In: Graham AW, Shultz TK (eds), Principles of Addiction Medicine, 3rd ed. American Society of Addiction Medicine, 2003:1231.
- 6. Wong S, Ordean A, Kahan M; Maternal Fetal Medicine Committee; Family Physicians Advisory Committee; Medico-Legal Committee; Ad Hoc Reviewers; Special Contributors. Substance use in pregnancy. J Obstet Gynaecol Can 2011;33:367-84.
- 7. Zahorec R. Ratio of neutrophil to lymphocyte counts- Rapid and simple parameter of systemic inflammation and stress n critically ill. Bratisl Lek Listy 2001; 102:5-14.
- 8. Costello EJ, Copeland WE, Shanahan L, Worthman CM, Angold A. C-Reactive Protein and substance use disorders in adolescence and early adulthood: A prospective analysis. Drug Alcohol Depend 2013;133:712–7.
- 9. Finnegan LP, Connaughton JF Jr, Kron RE, Emich JP. Neonatal abstinence syndrome: Assessment and management. Addict Dis 1975;2:141–58.
- 10. Hudak ML, Tan RC. Neonatal drug withdrawal. Pediatrics 2012;129:540-60.
- 11. Bagley SM, Wachman EM, Holland E, Brogly SB. Review of the assessment and management of neonatal abstinence syndrome. Addict Sci Clin Pract 2014;9:19.
- 12. Tetstall E, Liu AJ, An EI, Canalese J, Nanan R. Pregnancy and neonatal characteristics of opioid-dependent Indigenous Australians: A rural and metropolitan comparison. Aust N Z J Obstet Gynaecol 2009;49: 279–84.
- 13. Huybrechts KF, Bateman BT, Desai RJ, Hernandez-Diaz S, Rough K, Mogun H, et al. Risk of neonatal drug withdrawal after intrauterine co-exposure to opioids and psychotropic medications: Cohort study. BMJ 2017;358:3326.
- 14. Hall ES, Wexelblatt SL, Crowley M, Grow JL, Jasin LR, Klebanoff MA, et al. OCHNAS Consortium. A multicenter cohort study of treatments and hospital outcomes in neonatal abstinence syndrome. Pediatrics 2014;134:e527-34.
- 15. ACOG Committee on Practice Bulletins; Use of psychiatric medications during pregnancy and lactation. Obstet Gynecol 2008;111:1001–20.
- 16. Shainker SA, Saia K, Lee-Parritz A. Opioid addiction in pregnancy. Obstet Gynecol Surv 2012;67:817–25.
- 17. Behnke M, Eyler FD. The consequences of prenatal substance use for the developing fetus, newborn and young child. Int J Addict 1993;28:1341-91.
- 18. Grossman MR, Berkwitt AK, Osborn RR. An initiative to improve the quality of care of infants with neonatal abstinence syndrome. Pediatrics 2017;139:e20163360.
- 19. 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;74:241-6.
- 20. Kwon JH, Jang JW, Kim YW, Lee SW, Nam SW, Jaegal D, et al. The usefulness of C-reactive protein and neutrophil-to-lymphocyte ratio for predicting the outcome in hospitalized patients with liver cirrhosis. BMC Gastroenterol 2015;15:146.
- 21. Yazar FM, Bakacak M, Emre A, Urfalıoglu A, Serin S, Cengiz E, et al. Predictive role of neutrophil-to-lymphocyte and plateletto- lymphocyte ratios for diagnosis of acute appendicitis during pregnancy. Kaohsiung J Med Sci 2015;31:591-6.
- 22. Demir AK, Demirtas A, Kaya SU, Tastan I, Butun I, Sagcan M, et al. The relationship between the neutrophilelymphocyte ratio and disease activity in patients with ulcerative colitis. Kaohsiung J Med Sci 2015;31:585-90.
- 23. Özkan N, Sonmez MB, Durmus P Tas, Gorgulu Y, Cınar R Kose, Vardar ME. Elevated neutrophil lymphocyte ratio in patients with substance use disorders. European Psychiatry 2017;41:S872-S873.
- 24. Catal F, Tayman C, Tonbul A, Akça H, Kara S, Tatli MM, et al. Mean platelet volume (MPV) may simply predict the severity of sepsis in preterm infants. Clin Lab 2014;60:1193-200.
- 25. Witt CE, Rudd KE, Bhatraju P, Rivara FP, Hawes SE, Weiss NS. Neonatal abstinence syndrome and early childhood morbidity and mortality in Washington state: A retrospective cohort study.J Perinatol 2017;37:1124-9.
- 26. Povroznik JM, Engler-Chiurazzi, Nanavati T, Pergami P. Absolute lymphocyte and neutrophil counts in neonatal ischemic brain injury. SAGE Open Med 2018;6:2050312117752613.
Evaluation of Neonatal Abstinence Syndrome (NAS) Frequency and Systemic Inflammatory Response in NAS
Öz
Kaynakça
- 1. Kocherlakota P. Neonatal Abstinence Syndrome. Pediatrics 2014;134:e547–61.
- 2. Tolia VN, Patrick SW, Bennett MM. Increasing incidence of the neonatal abstinence syndrome in U.S. neonatal ICUs. N Engl J Med 2015; 372:2118-26.
- 3. Goler NC, Armstrong MA, Taillac CJ, Osejo VM. Substance abuse treatment linked with prenatal visits improves perinatal outcomes: A new standard. J Perinatol 2008; 28:597-603.
- 4. WHO. Guidelines for identification and management of substance use and substance use disorders in pregnancy World Health Organization. 2014:224.
- 5. Weaver MF. Perinatal addiction. In: Graham AW, Shultz TK (eds), Principles of Addiction Medicine, 3rd ed. American Society of Addiction Medicine, 2003:1231.
- 6. Wong S, Ordean A, Kahan M; Maternal Fetal Medicine Committee; Family Physicians Advisory Committee; Medico-Legal Committee; Ad Hoc Reviewers; Special Contributors. Substance use in pregnancy. J Obstet Gynaecol Can 2011;33:367-84.
- 7. Zahorec R. Ratio of neutrophil to lymphocyte counts- Rapid and simple parameter of systemic inflammation and stress n critically ill. Bratisl Lek Listy 2001; 102:5-14.
- 8. Costello EJ, Copeland WE, Shanahan L, Worthman CM, Angold A. C-Reactive Protein and substance use disorders in adolescence and early adulthood: A prospective analysis. Drug Alcohol Depend 2013;133:712–7.
- 9. Finnegan LP, Connaughton JF Jr, Kron RE, Emich JP. Neonatal abstinence syndrome: Assessment and management. Addict Dis 1975;2:141–58.
- 10. Hudak ML, Tan RC. Neonatal drug withdrawal. Pediatrics 2012;129:540-60.
- 11. Bagley SM, Wachman EM, Holland E, Brogly SB. Review of the assessment and management of neonatal abstinence syndrome. Addict Sci Clin Pract 2014;9:19.
- 12. Tetstall E, Liu AJ, An EI, Canalese J, Nanan R. Pregnancy and neonatal characteristics of opioid-dependent Indigenous Australians: A rural and metropolitan comparison. Aust N Z J Obstet Gynaecol 2009;49: 279–84.
- 13. Huybrechts KF, Bateman BT, Desai RJ, Hernandez-Diaz S, Rough K, Mogun H, et al. Risk of neonatal drug withdrawal after intrauterine co-exposure to opioids and psychotropic medications: Cohort study. BMJ 2017;358:3326.
- 14. Hall ES, Wexelblatt SL, Crowley M, Grow JL, Jasin LR, Klebanoff MA, et al. OCHNAS Consortium. A multicenter cohort study of treatments and hospital outcomes in neonatal abstinence syndrome. Pediatrics 2014;134:e527-34.
- 15. ACOG Committee on Practice Bulletins; Use of psychiatric medications during pregnancy and lactation. Obstet Gynecol 2008;111:1001–20.
- 16. Shainker SA, Saia K, Lee-Parritz A. Opioid addiction in pregnancy. Obstet Gynecol Surv 2012;67:817–25.
- 17. Behnke M, Eyler FD. The consequences of prenatal substance use for the developing fetus, newborn and young child. Int J Addict 1993;28:1341-91.
- 18. Grossman MR, Berkwitt AK, Osborn RR. An initiative to improve the quality of care of infants with neonatal abstinence syndrome. Pediatrics 2017;139:e20163360.
- 19. 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;74:241-6.
- 20. Kwon JH, Jang JW, Kim YW, Lee SW, Nam SW, Jaegal D, et al. The usefulness of C-reactive protein and neutrophil-to-lymphocyte ratio for predicting the outcome in hospitalized patients with liver cirrhosis. BMC Gastroenterol 2015;15:146.
- 21. Yazar FM, Bakacak M, Emre A, Urfalıoglu A, Serin S, Cengiz E, et al. Predictive role of neutrophil-to-lymphocyte and plateletto- lymphocyte ratios for diagnosis of acute appendicitis during pregnancy. Kaohsiung J Med Sci 2015;31:591-6.
- 22. Demir AK, Demirtas A, Kaya SU, Tastan I, Butun I, Sagcan M, et al. The relationship between the neutrophilelymphocyte ratio and disease activity in patients with ulcerative colitis. Kaohsiung J Med Sci 2015;31:585-90.
- 23. Özkan N, Sonmez MB, Durmus P Tas, Gorgulu Y, Cınar R Kose, Vardar ME. Elevated neutrophil lymphocyte ratio in patients with substance use disorders. European Psychiatry 2017;41:S872-S873.
- 24. Catal F, Tayman C, Tonbul A, Akça H, Kara S, Tatli MM, et al. Mean platelet volume (MPV) may simply predict the severity of sepsis in preterm infants. Clin Lab 2014;60:1193-200.
- 25. Witt CE, Rudd KE, Bhatraju P, Rivara FP, Hawes SE, Weiss NS. Neonatal abstinence syndrome and early childhood morbidity and mortality in Washington state: A retrospective cohort study.J Perinatol 2017;37:1124-9.
- 26. Povroznik JM, Engler-Chiurazzi, Nanavati T, Pergami P. Absolute lymphocyte and neutrophil counts in neonatal ischemic brain injury. SAGE Open Med 2018;6:2050312117752613.
Toplam 26 adet kaynakça vardır.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Konular | İç Hastalıkları |
| Bölüm | ORIGINAL ARTICLES |
| Yazarlar | |
| Yayımlanma Tarihi | 24 Mayıs 2019 |
| Gönderilme Tarihi | 25 Aralık 2017 |
| Yayımlandığı Sayı | Yıl 2019 Cilt: 13 Sayı: 3 |
Cited By
Prenatal Substance Abuse: a 1-Year Single-Center Experience at a Tertiary Neonatal Intensive Care Unit
Turkish Journal of Pediatric Disease
https://doi.org/10.12956/tchd.1284603