使用脐带血和新生儿胎粪进行硬膜外镇痛输注时芬太尼母婴传播的前瞻性观察研究。

IF 2.4 3区医学 Q2 OBSTETRICS & GYNECOLOGY

Journal of Perinatology Pub Date : 2025-09-18 DOI:10.1038/s41372-025-02416-9

Nanyaly M Santiago-Aponte, Dongxiao Sun, Tonya S King, Tammy E Corr

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引用次数: 0

摘要

目的：确定胎儿暴露于母体硬膜外芬太尼是否会导致胎便药物试验阳性。研究设计：采用高效液相色谱-串联质谱法定量评价母亲接受硬膜外镇痛的≥37周婴儿脐带血和胎粪中的芬太尼水平。评估了产妇硬膜外用药剂量和持续时间与脐带血和胎粪中芬太尼水平之间的关系。结果：298例母婴中，芬太尼硬膜外麻醉的中位持续时间为6.8小时。硬膜外持续时间与胎粪中芬太尼水平呈正相关（Spearman ρ = 0.70, 95%CI[0.64-0.76]），硬膜外暴露bbbb4小时p 0.05 ng/g为93.9%。结论：产妇硬膜外分娩时间与胎粪中芬太尼含量呈正相关。提供者可以预期阳性胎便药物筛选芬太尼在设置产妇硬膜外。

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Prospective observational study quantifying maternal-fetal fentanyl transmission in epidural analgesia infusion using umbilical cord blood and neonatal meconium.

Objective: To determine whether fetal exposure to maternal epidural fentanyl can result in a positive meconium drug test.

Study design: Quantitative evaluation of fentanyl levels in cord blood and meconium of infants ≥37 weeks whose mothers received epidural analgesia was performed using High Performance Liquid Chromatography-tandem Mass Spectrometry. The association between dose and duration of maternal epidural and fentanyl levels in cord blood and meconium was evaluated.

Results: In 298 mother-infant dyads, median duration of fentanyl epidural was 6.8 hours. There was a strong positive correlation between epidural duration and fentanyl levels in meconium (Spearman rho = 0.70, 95%CI [0.64-0.76]), p < 0.001). Positive predictive value for fentanyl detection in meconium >0.05 ng/g for epidural exposure of >4 hours was 93.9%.

Conclusion: There is a strong positive correlation between maternal epidural duration and fentanyl in meconium. Providers can anticipate a positive meconium drug screen for fentanyl in the setting of a maternal epidural.

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来源期刊

Journal of Perinatology 医学-妇产科学

CiteScore

5.40

自引率

6.90%

发文量

284

审稿时长

3-8 weeks

期刊介绍： The Journal of Perinatology provides members of the perinatal/neonatal healthcare team with original information pertinent to improving maternal/fetal and neonatal care. We publish peer-reviewed clinical research articles, state-of-the art reviews, comments, quality improvement reports, and letters to the editor. Articles published in the Journal of Perinatology embrace the full scope of the specialty, including clinical, professional, political, administrative and educational aspects. The Journal also explores legal and ethical issues, neonatal technology and product development. The Journal’s audience includes all those that participate in perinatal/neonatal care, including, but not limited to neonatologists, perinatologists, perinatal epidemiologists, pediatricians and pediatric subspecialists, surgeons, neonatal and perinatal nurses, respiratory therapists, pharmacists, social workers, dieticians, speech and hearing experts, other allied health professionals, as well as subspecialists who participate in patient care including radiologists, laboratory medicine and pathologists.