SINDROM USTEZANJA OD OPIJATA U NOVOROĐENAČKOJ DOBI – ISKUSTVA DJELATNOSTI ZA PEDIJATRIJU OPĆE BOLNICE PULA (2001-2010)

Opiate abuse during pregnancy is a serious problem for both the mother and her newborn. The pregnancies of opiate abusing mothers are by definition high risk; the prenatal care is usually inadequate, abuse of alcohol, nicotine and other drugs is often present and there is a high incidence of hepatitis and HIV infections. Shortly after birth, neonates develop acute withdrawal symptoms. In Istria, in the period of 1996 to 2009 there were 2073 registered drug abusers, 355 of them were females. In our study, we present 29 newborns of opiate addicted mothers. The neonates were mostly born on term with spontaneous labor, were eutrophic and with normal Apgar scores. The withdrawal symptoms developed mainly (93%) in the first 48 hours; the most common symptoms were hyperphagia (100%), hyperirritability (79%), tremor (55%) and high-pitched cry (52%). All newborns were treated with Phenobarbital. The initial dose was 5-10 mg/kg/day in 3 to 4 divided doses and the maximal dose was 15 mg/kg/day. The duration of Phenobarbital therapy was 16,6±8,7 days and the hospital stay was 21,6±12,2 days respectively. The cost of the treatment was 13158,8±5563,3 kn. Two neonates were transported to the Pediatric Tertiary Care Center (Clinical Hospital Center Rijeka); one because of convulsions that couldn’t be managed with diazepam and Phenobarbital, and one because of apnoea after birth necessitating mechanical ventilation in an Intensive Care Unit. One newborn was referred to the Orthopedics’ ward because of major anomalies of extremities.