Neonatal Yoksunluk Sendromu (NYS) Sıklığı ve NYS’de Sistemik İnflamatuvar Yanıtın Değerlendirilmesi

Cüneyt Tayman

doi:10.12956/tjpd.2018.357

Öz

Amaç: Neonatal yoksunluk sendromu (NYS) görülme oranı giderek artan, ciddi bir sorundur. Türkiye’de gebelerdeyasadışı uyuşturucu kullanımı ve NYS oranı bilinmemektedir. Nötrofil lenfosit oranı (NLO) ve diğer akut faz belirteçlerisistemik inflamatuvar yanıtın göstergeleridir. Çalışmada NYS sıklığını ve NYS’ lu yenidoğanlarda akut faz belirteçleri veNLO değerlerinin ölçümünü amaçladık.

Gereç ve Yöntemler: Hastanemizde doğum yapan ve madde bağımlılığı saptanan annelerin bebekleri çalışmaya dâhiledildi. Ciddi sarılığı olmayan fototerapi için yatırılan infantlar kontrol grubu olarak değerlendirildi. Finnegan skoru ileNYS 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 grubundaanlamlı derecede yüksek olduğu izlendi (p<0.05). Neonatal yoksunluk sendromu bulguları nedeniyle ilaç tedavisi alanhastalarda NLO değerlerinin daha yüksek olduğu bulundu (p<0.05).

Sonuç: Neonatal yoksunluk sendromu ciddi morbidite ve mortaliteye neden olan ve giderek artan toplumsal birproblemdir. Bu ilaçlara intrauterin maruziyet yenidoğanda inflamatuvar süreci tetiklemektedir. NLO ve MPV değerlerininNYS’lu infantlarda yüksek olması inflamasyonu göstermektedir.

Anahtar Kelimeler: Eroin, Esrar, Gebelik, Neonatal yoksunluk sendromu

Referanslar

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Obstet Gynecol Surv 2012;67:817–25.
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1993;28:1341-91.
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the quality of care of infants with neonatal abstinence syndrome.
Pediatrics 2017;139:e20163360.
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SW. Neonatal outcome following maternal opiate use in late
pregnancy. Int J Obstet Gynaecol 2001;74:241-6.
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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.
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lymphocyte and neutrophil counts in neonatal ischemic brain injury.
SAGE Open Med 2018;6:2050312117752613.

Telif hakkı ve lisans

Nasıl atıf yapılır

Tayman C. Neonatal Yoksunluk Sendromu (NYS) Sıklığı ve NYS’de Sistemik İnflamatuvar Yanıtın Değerlendirilmesi. Turk J Pediatr Dis [Internet]. 2019 May 24 [cited 2025 May 25];13(3):171-6. Available from: https://turkjpediatrdis.org/article/view/609

Atıf indir

[ref1] 1. Kocherlakota P. Neonatal Abstinence Syndrome. Pediatrics

[ref2] 2014;134:e547–61.

[ref3] 2. Tolia VN, Patrick SW, Bennett MM. Increasing incidence of the

[ref4] neonatal abstinence syndrome in U.S. neonatal ICUs. N Engl J

[ref5] Med 2015; 372:2118-26.

[ref6] 3. Goler NC, Armstrong MA, Taillac CJ, Osejo VM. Substance abuse

[ref7] treatment linked with prenatal visits improves perinatal outcomes:

[ref8] A new standard. J Perinatol 2008; 28:597-603.

[ref9] 4. WHO. Guidelines for identification and management of substance

[ref10] use and substance use disorders in pregnancy World Health

[ref11] Organization. 2014:224.

[ref12] 5. Weaver MF. Perinatal addiction. In: Graham AW, Shultz TK (eds),

[ref13] Principles of Addiction Medicine, 3rd ed. American Society of

[ref14] Addiction Medicine, 2003:1231.

[ref15] 6. Wong S, Ordean A, Kahan M; Maternal Fetal Medicine Committee;

[ref16] Family Physicians Advisory Committee; Medico-Legal Committee;

[ref17] Ad Hoc Reviewers; Special Contributors. Substance use in

[ref18] pregnancy. J Obstet Gynaecol Can 2011;33:367-84.

[ref19] 7. Zahorec R. Ratio of neutrophil to lymphocyte counts- Rapid and

[ref20] simple parameter of systemic inflammation and stress n critically ill.

[ref21] Bratisl Lek Listy 2001; 102:5-14.

[ref22] 8. Costello EJ, Copeland WE, Shanahan L, Worthman CM, Angold A.

[ref23] C-Reactive Protein and substance use disorders in adolescence

[ref24] and early adulthood: A prospective analysis. Drug Alcohol Depend

[ref25] 2013;133:712–7.

[ref26] 9. Finnegan LP, Connaughton JF Jr, Kron RE, Emich JP. Neonatal

[ref27] abstinence syndrome: Assessment and management. Addict Dis

[ref28] 1975;2:141–58.

[ref29] 10. Hudak ML, Tan RC. Neonatal drug withdrawal. Pediatrics

[ref30] 2012;129:540-60.

[ref31] 11. Bagley SM, Wachman EM, Holland E, Brogly SB. Review of the

[ref32] assessment and management of neonatal abstinence syndrome.

[ref33] Addict Sci Clin Pract 2014;9:19.

[ref34] 12. Tetstall E, Liu AJ, An EI, Canalese J, Nanan R. Pregnancy

[ref35] and neonatal characteristics of opioid-dependent Indigenous

[ref36] Australians: A rural and metropolitan comparison. Aust N Z J

[ref37] Obstet Gynaecol 2009;49: 279–84.

[ref38] 13. Huybrechts KF, Bateman BT, Desai RJ, Hernandez-Diaz S,

[ref39] Rough K, Mogun H, et al. Risk of neonatal drug withdrawal after

[ref40] intrauterine co-exposure to opioids and psychotropic medications:

[ref41] Cohort study. BMJ 2017;358:3326.

[ref42] 14. Hall ES, Wexelblatt SL, Crowley M, Grow JL, Jasin LR, Klebanoff

[ref43] MA, et al. OCHNAS Consortium. A multicenter cohort study

[ref44] of treatments and hospital outcomes in neonatal abstinence

[ref45] syndrome. Pediatrics 2014;134:e527-34.

[ref46] 15. ACOG Committee on Practice Bulletins; Use of psychiatric

[ref47] medications during pregnancy and lactation. Obstet Gynecol

[ref48] 2008;111:1001–20.

[ref49] 16. Shainker SA, Saia K, Lee-Parritz A. Opioid addiction in pregnancy.

[ref50] Obstet Gynecol Surv 2012;67:817–25.

[ref51] 17. Behnke M, Eyler FD. The consequences of prenatal substance use

[ref52] for the developing fetus, newborn and young child. Int J Addict

[ref53] 1993;28:1341-91.

[ref54] 18. Grossman MR, Berkwitt AK, Osborn RR. An initiative to improve

[ref55] the quality of care of infants with neonatal abstinence syndrome.

[ref56] Pediatrics 2017;139:e20163360.

[ref57] 19. Sinha C, Ohadike P, Carrick P, Pairaudeau P, Armstrong D, Lindow

[ref58] SW. Neonatal outcome following maternal opiate use in late

[ref59] pregnancy. Int J Obstet Gynaecol 2001;74:241-6.

[ref60] 20. Kwon JH, Jang JW, Kim YW, Lee SW, Nam SW, Jaegal D, et al.

[ref61] The usefulness of C-reactive protein and neutrophil-to-lymphocyte

[ref62] ratio for predicting the outcome in hospitalized patients with liver

[ref63] cirrhosis. BMC Gastroenterol 2015;15:146.

[ref64] 21. Yazar FM, Bakacak M, Emre A, Urfalıoglu A, Serin S, Cengiz E,

[ref65] et al. Predictive role of neutrophil-to-lymphocyte and plateletto-

[ref66] lymphocyte ratios for diagnosis of acute appendicitis during

[ref67] pregnancy. Kaohsiung J Med Sci 2015;31:591-6.

[ref68] 22. Demir AK, Demirtas A, Kaya SU, Tastan I, Butun I, Sagcan M, et

[ref69] al. The relationship between the neutrophilelymphocyte ratio and

[ref70] disease activity in patients with ulcerative colitis. Kaohsiung J Med

[ref71] Sci 2015;31:585-90.

[ref72] 23. Özkan N, Sonmez MB, Durmus P Tas, Gorgulu Y, Cınar R

[ref73] Kose, Vardar ME. Elevated neutrophil lymphocyte ratio in

[ref74] patients with substance use disorders. European Psychiatry

[ref75] 2017;41:S872-S873.

[ref76] 24. Catal F, Tayman C, Tonbul A, Akça H, Kara S, Tatli MM, et al. Mean

[ref77] platelet volume (MPV) may simply predict the severity of sepsis in

[ref78] preterm infants. Clin Lab 2014;60:1193-200.

[ref79] 25. Witt CE, Rudd KE, Bhatraju P, Rivara FP, Hawes SE, Weiss NS.

[ref80] Neonatal abstinence syndrome and early childhood morbidity

[ref81] and mortality in Washington state: A retrospective cohort study.J

[ref82] Perinatol 2017;37:1124-9.

[ref83] 26. Povroznik JM, Engler-Chiurazzi, Nanavati T, Pergami P. Absolute

[ref84] lymphocyte and neutrophil counts in neonatal ischemic brain injury.

[ref85] SAGE Open Med 2018;6:2050312117752613.

Türkiye Çocuk Hastalıkları Dergisi

Neonatal Yoksunluk Sendromu (NYS) Sıklığı ve NYS’de Sistemik İnflamatuvar Yanıtın Değerlendirilmesi

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Referanslar

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