A Multiple-Methods Study Exploring the Impact of Medication Exposure Among Neonates With In-Utero SSRI Exposure (NeoWISE) who are Breastfed in the First Month of Life
Notice bibliographique
Résumé
Background: Perinatal mental health disorders are common; adequate treatment is necessary for maternal, fetal, and newborn well-being. Neonates with in-utero selective serotonin reuptake inhibitor (SSRI) exposure (NeoWISE) may experience withdrawal signs. There is a lack of high-quality evidence to substantiate clinical practice recommendations for this population. Objective: To explore and develop evidence regarding the impact of in-utero SSRI exposure among newborns who are breastfed in the first month of life. Methods: Multiple-methods were used in this two-phase study. Phase I, a scoping review using JBI methodology, examined the extent and the type of evidence available in published literature. Phase II, a retrospective cohort study (NeoWISE), determined the impact of newborn feeding method on adverse outcomes and healthcare utilization in this population. Results: The scoping review included 28 studies, published between 1995 to 2023, representing a total of 393 newborns. Authors used a range of methodologies; case reports were the most common. Most studies included data collected during hospitalization after birth. Newborns were primarily full-term (≥ 37 weeks gestation). Respiratory difficulties were the most noted adverse outcome. The most reported healthcare utilization was admission to the NICU. Severe morbidity was rare. The NeoWISE Cohort included 5,079 newborns, born between April 1, 2012, to March 31, 2020 to beneficiaries of the Ontario Drug Benefit Program, of which 3,321 (65.4%) were exclusively breastfed from birth to hospital discharge. Among the breastfed newborns, 50 (1.5%) had neonatal withdrawal versus 41 (2.3%) newborns who were formula-fed, with no difference in risk of withdrawal (adjRR 0.86, 95% CI 0.56, 1.34). Breastfed newborns as compared with formula-fed newborns had a reduced risk of transfer to the NICU (adjRR 0.80, 95% CI 0.66, 0.97) and prolonged hospital stay (≥ 3 days) (adjRR 0.84, 95% CI 0.72, 0.97), and a higher risk of emergency department visits (adjRR 1.42, 95% CI 1.03, 1.97) and hospital readmission (adjRR 1.78, 95% CI 1.21, 2.62). Impact: We gain a better understanding of the impact of feeding methods on NeoWISE. The knowledge generated assists in the development of evidence-based newborn feeding and care recommendations to enable shared decision-making between health care providers and perinatal families.
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Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,001 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».