Medicine
Sanaz Yasrebinia; Mansour Rezaei
Abstract
Introduction: This study aiming to provide vital insights into the potential impacts of these treatment modalities (morphine or methadone) on the neurodevelopmental trajectories of Neonatal Abstinence Syndrome (NAS) -affected infants. By investigating the potential disparities in neurodevelopmental outcomes ...
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Introduction: This study aiming to provide vital insights into the potential impacts of these treatment modalities (morphine or methadone) on the neurodevelopmental trajectories of Neonatal Abstinence Syndrome (NAS) -affected infants. By investigating the potential disparities in neurodevelopmental outcomes associated with morphine and methadone, we aspire to inform evidence-based treatment decisions and refine the standard of care for NAS.Material and Methods: Eight participating locations included 116 full-term newborns diagnosed with NAS, born to mothers under methadone or buprenorphine maintenance, who were enrolled in a randomized trial comparing morphine to methadone. Upon hospital discharge, 99 of these infants (representing 85% of the cohort) underwent assessment using the NICU Network Neurobehavioral Scale (NNNS). At the 18-month mark, 83 out of the 99 infants (approximately 83.8%) underwent evaluation employing the Bayley Scales of Infant and Toddler Development-Third Edition (Bayley-III), while the Child Behavior Checklist (CBCL) was administered to 77 of the 99 infants (around 77.7%).Results: Our adjusted analyses further revealed that internalizing and total behavior problems were linked to the utilization of phenobarbital (p=0.03 and p=0.04, respectively), elevated levels of maternal psychological distress (as measured by the Brief Symptom Inventory) (both p<0.01), and the presence of infant medical issues (both p=0.02). Additionally, externalizing problems were associated with maternal psychological distress (p<0.01) and continued maternal substance use (p<0.01).Conclusion: Neonates administered either morphine or methadone exhibited comparable neurobehavioral outcomes in both the short and long term. The neurodevelopmental progress of these infants may be associated with factors such as the requirement for phenobarbital, the general health of the infant, and the quality of postnatal caregiving.
Medicine
Sanaz Yasrebinia; Mansour Rezaei
Abstract
Introduction: As the global community strives to ensure the health and well-being of mothers and newborns, AI emerges as a powerful ally in this noble endeavor. Through this systematic review, we seek to provide a comprehensive overview of the state of AI-driven mortality prediction, offering insights ...
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Introduction: As the global community strives to ensure the health and well-being of mothers and newborns, AI emerges as a powerful ally in this noble endeavor. Through this systematic review, we seek to provide a comprehensive overview of the state of AI-driven mortality prediction, offering insights that may shape the future of maternal and neonatal healthcare and bring us closer to the goal of ensuring safe pregnancies and healthy beginnings for all. Material and methods: We systematically reviewed the literature, restricting our search to publications from the past decade, and utilized the five major scientific databases as primary sources. Results: Out of the initial pool of 671 works, a total of 18 primary studies were meticulously chosen for in-depth analysis. It was evident that a predominant focus of these studies revolved around the prediction of neonatal mortality, predominantly employing machine learning models, with Random Forest being a popular choice. The top five frequently utilized features for model training encompassed birth weight, gestational age, the child's gender, Apgar score, and the mother's age. The development of predictive models for mitigating mortality during and after pregnancy holds immense potential, not only for enhancing the quality of life for mothers but also as a potent and cost-effective tool for reducing mortality rates. Conclusion: Drawing from the findings of this systematic review, it becomes evident that substantial scientific endeavors have been undertaken in this domain. However, it is equally apparent that numerous unexplored research avenues and opportunities await further exploration within the research community.
