Prenatal opioid and non-opioid substance exposure in Türkiye: The prospective multicenter NAS-TR cohort study of the Turkish neonatal society.
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Kahvecioglu Dilek, Gungor Melda Tas, Kavurt Sumru, Bulut Ismail, Abbasoglu Aslihan, Akca Deniz, Gulası Selvi, Bulut Huseyin Cagri, Kececi Ramazan, Kenar Aytac, Kraja Elvis, Ovalı Husnu Fahri, Saymazlar Dilek Damla, Kızılelma Avidan, Tutak Ercan, Okur Nilufer Matur, Tuncel Duygu, Simsek Huseyin, Akcalı Mustafa, Karacaglar Bengu, Turk Seyma Butun, Celik Kiymet, Ongun Hakan, Çakmak Çelik Fatma, Narter Fatma Kaya, Koyuncu Ece, Pekal Yucel, Varal Ipek Guney, Bagcı Onur, Bilgen Hulya Selva, Gok Nazife Reyyan, Buyukkale Gokhan, Semerci Seda Yılmaz, Bulbul Ali, Coskun Yusuf Iskender, Konak Murat, Uygun Saime Sundus, Ulu Ersin, Geyık Cem, Akbas Ozgul Tunc, Acunas Betul, Cetınkaya Merih, Aylanc Hakan, Kızıl Alaattin, Tufan Nihan, Canpolat Arife, Gunlemez Ayla, Buker Halime Sema Can, Tarakcı Nuriye, Sarıcı Dilek, Koc Esin
Аннотация
OBJECTIVE: To characterize opioid and non-opioid prenatal substance exposures, neonatal manifestations, management, short-term outcomes, and factors associated with pharmacological treatment and prolonged hospitalization in Türkiye.
METHODS: This prospective observational study enrolled infants aged 0-28 days who were clinically diagnosed with NAS following documented prenatal opioid or non-opioid substance exposure at 32 neonatal intensive care units between September 2, 2024, and September 2, 2025. Exposure classification relied predominantly on self-report, with limited toxicological confirmation. Multivariable logistic regression evaluated factors associated with pharmacological treatment and hospitalization lasting >18 days.
RESULTS: Among 137 infants from 17 provinces, stimulant-only exposure was the most common single-group pattern (51/137, 37.2%), and methamphetamine was the most frequently identified substance (57/137, 41.6%). Pharmacological treatment was given to 50 infants (36.5%), most commonly phenobarbital; morphine-containing regimens were used in four. Maximum Finnegan score independently predicted pharmacological treatment (adjusted OR 1.53 per point, 95% CI 1.30-1.80). Prolonged hospitalization was associated with maximum Finnegan score, gestational age, 1-minute Apgar score, and abandoned-infant status, with the latter showing the strongest association (adjusted OR 6.00, 95% CI 2.38-15.10).
CONCLUSION: This prospective multicenter cohort from Türkiye demonstrated a stimulant-predominant exposure pattern distinct from opioid-dominant cohorts. Clinical severity, rather than exposure group, independently predicted pharmacological treatment, while abandoned infant status was the strongest determinant of prolonged hospitalization. National pathways should address diagnostic heterogeneity, treatment resources, and social-care barriers.