Prenatal opioid and non-opioid substance exposure in Türkiye: The prospective multicenter NAS-TR cohort study of the Turkish neonatal society

KAHVECİOĞLU, Dilek; Gungor, Melda; Kavurt, Sumru; Bulut, Ismail; Abbasoglu, Aslihan; Akca, Deniz; GÜLAŞI, Selvi; Bulut, Huseyin; Kececi, Ramazan; Kenar, Aytac; Kraja, Elvis; Ovalı, Husnu; Saymazlar, Dilek; Kızılelma, Avidan; Tutak, Ercan; Okur, Nilufer; Tuncel, Duygu; Simsek, Huseyin; Akcalı, Mustafa; Karacaglar, Bengu; Turk, Seyma; Celik, Kiymet; Ongun, Hakan; ÇAKMAK ÇELİK, Fatma; NARTER, Fatma; Koyuncu, Ece; Pekal, Yucel; GÜNEY VARAL, İpek; Bagcı, Onur; Bilgen, Hulya; Gok, Nazife; BÜYÜKKALE, Gökhan; Semerci, Seda; BÜLBÜL, Ali; Coskun, Yusuf; Konak, Murat; Uygun, Saime; ULU, ERSİN; Geyık, Cem; Akbas, Ozgul; Acunas, Betul; Cetınkaya, Merih; AYLANÇ, HAKAN; Kızıl, Alaattin; Tufan, Nihan; Canpolat, Arife; GÜNLEMEZ, AYLA; Buker, Halime; Tarakcı, Nuriye; SARICI, Dilek; Koc, Esin

doi:10.1016/j.earlhumdev.2026.106656

Prenatal opioid and non-opioid substance exposure in Türkiye: The prospective multicenter NAS-TR cohort study of the Turkish neonatal society

KAHVECİOĞLU D., Gungor M. T., Kavurt S., Bulut I., Abbasoglu A., Akca D., ...Daha Fazla

Early Human Development, cilt.224, 2027 (SCI-Expanded, Scopus)

Yayın Türü: Makale / Tam Makale
Cilt numarası: 224
Basım Tarihi: 2027
Doi Numarası: 10.1016/j.earlhumdev.2026.106656
Dergi Adı: Early Human Development
Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, BIOSIS, CINAHL, EMBASE, MEDLINE, Academic Search Ultimate (EBSCO)
Anahtar Kelimeler: Neonatal abstinence syndrome, Neonatal outcomes, Non-opioid exposure, Opioid exposure, Prenatal substance exposure, Türkiye
Sağlık Bilimleri Üniversitesi Adresli: Evet

Özet

Background: Evidence on neonatal manifestations following prenatal substance exposure outside opioid-dominant settings is limited, and Türkiye lacks national multicenter data on exposure patterns and neonatal care. Objective: To characterize opioid and non-opioid prenatal substance exposures, neonatal manifestations, management, short-term outcomes, and factors associated with pharmacological treatment and prolonged hospitalization in Türkiye. Methods: This prospective observational study enrolled infants aged 0–28 days who were clinically diagnosed with NAS following documented prenatal opioid or non-opioid substance exposure at 32 neonatal intensive care units between September 2, 2024, and September 2, 2025. Exposure classification relied predominantly on self-report, with limited toxicological confirmation. Multivariable logistic regression evaluated factors associated with pharmacological treatment and hospitalization lasting >18 days. Results: Among 137 infants from 17 provinces, stimulant-only exposure was the most common single-group pattern (51/137, 37.2%), and methamphetamine was the most frequently identified substance (57/137, 41.6%). Pharmacological treatment was given to 50 infants (36.5%), most commonly phenobarbital; morphine-containing regimens were used in four. Maximum Finnegan score independently predicted pharmacological treatment (adjusted OR 1.53 per point, 95% CI 1.30–1.80). Prolonged hospitalization was associated with maximum Finnegan score, gestational age, 1-minute Apgar score, and abandoned-infant status, with the latter showing the strongest association (adjusted OR 6.00, 95% CI 2.38–15.10). Conclusion: This prospective multicenter cohort from Türkiye demonstrated a stimulant-predominant exposure pattern distinct from opioid-dominant cohorts. Clinical severity, rather than exposure group, independently predicted pharmacological treatment, while abandoned infant status was the strongest determinant of prolonged hospitalization. National pathways should address diagnostic heterogeneity, treatment resources, and social-care barriers.