Clinical features and risk factors associated with prenatal exposure to drugs of abuse
Introduction: Early identification of neonates exposed to drugs of abuse during pregnancy allows a more precise clinical management. Objectives: To describe the clinical characteristics and to identify risk factors associated with the early detection of neonates exposed to drugs of abuse in a Neonat...
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Elsevier
2021
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Exposición prenatal Unidad de Cuidados Intensivos Neonatales Biomarcadores Meconio Pediatrics RJ1-570 |
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Exposición prenatal Unidad de Cuidados Intensivos Neonatales Biomarcadores Meconio Pediatrics RJ1-570 Antonia Roca Pilar Jarque Isabel Gomila Emilia Marchei Roberta Tittarelli Miguel Ángel Elorza Pilar Sanchís Bernardino Barceló Clinical features and risk factors associated with prenatal exposure to drugs of abuse |
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Introduction: Early identification of neonates exposed to drugs of abuse during pregnancy allows a more precise clinical management. Objectives: To describe the clinical characteristics and to identify risk factors associated with the early detection of neonates exposed to drugs of abuse in a Neonatal Intermediate and Intensive Care Unit. Methods: Prospective observational study of neonates with and without clinical suspicion of prenatal exposure to drugs of abuse. Meconium was analyzed using standard chromatographic techniques. Univariate and multivariate statistical analyzes were performed. Results: 372 neonates were included. Exposure to drugs of abuse was detected in 49 (13.2%) cases: in 41 (83.7%) one drug and in 8 (16.3%) more than one. Somatometry at birth revealed: a) lower length percentile in those exposed to some drug, more than one and cannabis; b) lower weight percentile in those exposed to cannabis and of these compared to those exposed to alcohol. In neonates older than 34 pregnancy weeks (PW): a) lower length percentile in those exposed to any substance; b) lower percentile of length and weight in exposed to more than one. The most clinically relevant independent risk factors useful to detect cases of prenatal exposure to drugs of abuse were (Odds ratio (95% CI)): reason for admission other than prematurity (5.52 (2.55-1.93)), length percentile less than 33 (1.95 (1.05-3.60) and 2.14 (1.04-3.40) in older than 34 PW) and social dystocia/uncontrolled pregnancy in older than 34 PW (4.47 (1.03-19.29)). Conclusions: There are somatometric alterations and risk factors that can help in the early detection of neonates exposed to drugs of abuse. The somatometric alterations identified can be useful to extend the differential diagnosis of these alterations and to study their causes. Resumen: Introducción: La identificación temprana de los neonatos expuestos a drogas de abuso permite realizar un manejo clínico más preciso. Objetivos: Describir las características clínicas e identificar factores de riesgo asociados a la detección precoz de neonatos expuestos a drogas de abuso en una Unidad de Cuidados Intensivos e Intermedios Neonatales. Métodos: Estudio observacional prospectivo de neonatos con y sin sospecha clínica de exposición prenatal a drogas de abuso. Se analizó meconio empleando técnicas cromatográficas estandarizadas. Se realizaron análisis estadísticos univariante y multivariante. Resultados: Se incluyeron 372 neonatos. En 49 (13,2%) casos se detectó exposición a alguna droga de abuso; en 41 (83,7%) a una, y en ocho (16,3%) a más de una. La somatometría al nacimiento objetivó: a) menor percentil de longitud en expuestos a alguna droga, a más de una y a cannabis; b) menor percentil de peso en expuestos a cannabis, y de éstos en comparación con los expuestos a alcohol. En mayores de 34 semanas de gestación (SG): a) menor percentil de longitud en expuestos a alguna droga; b) menor percentil de longitud y peso en expuestos a más de una. Los factores de riesgo independientes clínicamente útiles para detectar casos de exposición prenatal a drogas de abuso fueron (odds ratio [IC 95%]): motivo de ingreso distinto a prematuridad (5,52 [2,55-1,93]), percentil de longitud menor a 33 (1,95 [1,05-3,60]) y (2,14 [1,04-3,40]) en mayores de 34 SG y distocia social/embarazo no controlado en mayores a 34SG (4,47 [1,03-19,29]). Conclusiones: Existen alteraciones somatométricas y factores de riesgo que pueden ayudar a detectar precozmente a los neonatos expuestos a drogas de abuso. Las alteraciones somatométricas identificadas pueden servir para ampliar su diagnóstico diferencial y el estudio de sus causas. |
| format |
article |
| author |
Antonia Roca Pilar Jarque Isabel Gomila Emilia Marchei Roberta Tittarelli Miguel Ángel Elorza Pilar Sanchís Bernardino Barceló |
| author_facet |
Antonia Roca Pilar Jarque Isabel Gomila Emilia Marchei Roberta Tittarelli Miguel Ángel Elorza Pilar Sanchís Bernardino Barceló |
| author_sort |
Antonia Roca |
| title |
Clinical features and risk factors associated with prenatal exposure to drugs of abuse |
| title_short |
Clinical features and risk factors associated with prenatal exposure to drugs of abuse |
| title_full |
Clinical features and risk factors associated with prenatal exposure to drugs of abuse |
| title_fullStr |
Clinical features and risk factors associated with prenatal exposure to drugs of abuse |
| title_full_unstemmed |
Clinical features and risk factors associated with prenatal exposure to drugs of abuse |
| title_sort |
clinical features and risk factors associated with prenatal exposure to drugs of abuse |
| publisher |
Elsevier |
| publishDate |
2021 |
| url |
https://doaj.org/article/0f44e40806e347ce9dbe87261cd8fdd0 |
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AT antoniaroca clinicalfeaturesandriskfactorsassociatedwithprenatalexposuretodrugsofabuse AT pilarjarque clinicalfeaturesandriskfactorsassociatedwithprenatalexposuretodrugsofabuse AT isabelgomila clinicalfeaturesandriskfactorsassociatedwithprenatalexposuretodrugsofabuse AT emiliamarchei clinicalfeaturesandriskfactorsassociatedwithprenatalexposuretodrugsofabuse AT robertatittarelli clinicalfeaturesandriskfactorsassociatedwithprenatalexposuretodrugsofabuse AT miguelangelelorza clinicalfeaturesandriskfactorsassociatedwithprenatalexposuretodrugsofabuse AT pilarsanchis clinicalfeaturesandriskfactorsassociatedwithprenatalexposuretodrugsofabuse AT bernardinobarcelo clinicalfeaturesandriskfactorsassociatedwithprenatalexposuretodrugsofabuse |
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1718431211939954688 |
| spelling |
oai:doaj.org-article:0f44e40806e347ce9dbe87261cd8fdd02021-11-12T04:36:26ZClinical features and risk factors associated with prenatal exposure to drugs of abuse2341-287910.1016/j.anpede.2020.08.013https://doaj.org/article/0f44e40806e347ce9dbe87261cd8fdd02021-11-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S2341287921001617https://doaj.org/toc/2341-2879Introduction: Early identification of neonates exposed to drugs of abuse during pregnancy allows a more precise clinical management. Objectives: To describe the clinical characteristics and to identify risk factors associated with the early detection of neonates exposed to drugs of abuse in a Neonatal Intermediate and Intensive Care Unit. Methods: Prospective observational study of neonates with and without clinical suspicion of prenatal exposure to drugs of abuse. Meconium was analyzed using standard chromatographic techniques. Univariate and multivariate statistical analyzes were performed. Results: 372 neonates were included. Exposure to drugs of abuse was detected in 49 (13.2%) cases: in 41 (83.7%) one drug and in 8 (16.3%) more than one. Somatometry at birth revealed: a) lower length percentile in those exposed to some drug, more than one and cannabis; b) lower weight percentile in those exposed to cannabis and of these compared to those exposed to alcohol. In neonates older than 34 pregnancy weeks (PW): a) lower length percentile in those exposed to any substance; b) lower percentile of length and weight in exposed to more than one. The most clinically relevant independent risk factors useful to detect cases of prenatal exposure to drugs of abuse were (Odds ratio (95% CI)): reason for admission other than prematurity (5.52 (2.55-1.93)), length percentile less than 33 (1.95 (1.05-3.60) and 2.14 (1.04-3.40) in older than 34 PW) and social dystocia/uncontrolled pregnancy in older than 34 PW (4.47 (1.03-19.29)). Conclusions: There are somatometric alterations and risk factors that can help in the early detection of neonates exposed to drugs of abuse. The somatometric alterations identified can be useful to extend the differential diagnosis of these alterations and to study their causes. Resumen: Introducción: La identificación temprana de los neonatos expuestos a drogas de abuso permite realizar un manejo clínico más preciso. Objetivos: Describir las características clínicas e identificar factores de riesgo asociados a la detección precoz de neonatos expuestos a drogas de abuso en una Unidad de Cuidados Intensivos e Intermedios Neonatales. Métodos: Estudio observacional prospectivo de neonatos con y sin sospecha clínica de exposición prenatal a drogas de abuso. Se analizó meconio empleando técnicas cromatográficas estandarizadas. Se realizaron análisis estadísticos univariante y multivariante. Resultados: Se incluyeron 372 neonatos. En 49 (13,2%) casos se detectó exposición a alguna droga de abuso; en 41 (83,7%) a una, y en ocho (16,3%) a más de una. La somatometría al nacimiento objetivó: a) menor percentil de longitud en expuestos a alguna droga, a más de una y a cannabis; b) menor percentil de peso en expuestos a cannabis, y de éstos en comparación con los expuestos a alcohol. En mayores de 34 semanas de gestación (SG): a) menor percentil de longitud en expuestos a alguna droga; b) menor percentil de longitud y peso en expuestos a más de una. Los factores de riesgo independientes clínicamente útiles para detectar casos de exposición prenatal a drogas de abuso fueron (odds ratio [IC 95%]): motivo de ingreso distinto a prematuridad (5,52 [2,55-1,93]), percentil de longitud menor a 33 (1,95 [1,05-3,60]) y (2,14 [1,04-3,40]) en mayores de 34 SG y distocia social/embarazo no controlado en mayores a 34SG (4,47 [1,03-19,29]). Conclusiones: Existen alteraciones somatométricas y factores de riesgo que pueden ayudar a detectar precozmente a los neonatos expuestos a drogas de abuso. Las alteraciones somatométricas identificadas pueden servir para ampliar su diagnóstico diferencial y el estudio de sus causas.Antonia RocaPilar JarqueIsabel GomilaEmilia MarcheiRoberta TittarelliMiguel Ángel ElorzaPilar SanchísBernardino BarcelóElsevierarticleExposición prenatalUnidad de Cuidados Intensivos NeonatalesBiomarcadoresMeconioPediatricsRJ1-570ESAnales de Pediatría (English Edition), Vol 95, Iss 5, Pp 307-320 (2021) |