Journal of perinatology : official journal of the California Perinatal Association · 2024
Prediction of site-specific pharmacologic therapy among newborns with neonatal opioid withdrawal syndrome.
СтатьяМногоцентровое исследованиеНазвание и аннотация: Перевод в очереди
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Coyle Mara G, Ounpraseuth Songthip T, Lester Barry, Dansereau Lynne M, Hu Zhuopei, Laptook Abbot, Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network and the NIH Environmental Influences on Child Health Outcomes (ECHO) Program Institutional Development Awards States Pediatric Clinical Trials Network
Аннотация
OBJECTIVE: To predict pharmacotherapy for NOWS based on factors available shortly after birth.
STUDY DESIGN: A multi-center, retrospective study of 1377 opioid exposed newborns between 2016 and 2017 dichotomized based on pharmacologic treatment (N = 665 treated, N = 712 not treated) was conducted. A multilevel mixed-effect logistic regression model that considered cluster effect from sites determined significant maternal and newborn factors associated with pharmacotherapy, which were combined in a nomogram to predict probability of treatment for infants at each participating site.
RESULTS: Factors predictive of treatment were: no breastmilk (1.76, 1.30-2.39; p < 0.001), male sex (1.39, 1.05-1.83; p = 0.021), polysubstance exposure (1.53, 1.15-2.06; p = 0.004), inadequate prenatal care (1.51, 1.07-2.13; p < 0.018) and Methadone (6.08, 4.03-9.27; p < 0.001) or Buprenorphine (1.86, 1.29-2.69; p < 0.001). A site-specific nomogram provided the probability of treatment for individual newborns.
CONCLUSION: Six factors available shortly after birth can be combined to predict site-specific use of medication for NOWS. If confirmed, the nomogram may identify at-risk newborns.
STUDY DESIGN: A multi-center, retrospective study of 1377 opioid exposed newborns between 2016 and 2017 dichotomized based on pharmacologic treatment (N = 665 treated, N = 712 not treated) was conducted. A multilevel mixed-effect logistic regression model that considered cluster effect from sites determined significant maternal and newborn factors associated with pharmacotherapy, which were combined in a nomogram to predict probability of treatment for infants at each participating site.
RESULTS: Factors predictive of treatment were: no breastmilk (1.76, 1.30-2.39; p < 0.001), male sex (1.39, 1.05-1.83; p = 0.021), polysubstance exposure (1.53, 1.15-2.06; p = 0.004), inadequate prenatal care (1.51, 1.07-2.13; p < 0.018) and Methadone (6.08, 4.03-9.27; p < 0.001) or Buprenorphine (1.86, 1.29-2.69; p < 0.001). A site-specific nomogram provided the probability of treatment for individual newborns.
CONCLUSION: Six factors available shortly after birth can be combined to predict site-specific use of medication for NOWS. If confirmed, the nomogram may identify at-risk newborns.