{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T23:15:58Z","timestamp":1782342958737,"version":"3.54.5"},"reference-count":29,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,5,7]],"date-time":"2024-05-07T00:00:00Z","timestamp":1715040000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>An increased incidence of maternal opioid use disorder (OUD) and neonatal abstinence syndrome (NAS) has prompted recommendations supporting a dyadic approach to care for birthing persons and their infants. However, there are no consensus guidelines outlining how the dyad is clinically defined.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>To examine how the opioid-exposed birthing person-infant dyad has been defined for purposes of data collection and research, a literature review applying the RAND\/UCLA Appropriateness Method was conducted.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The search yielded 320 abstracts, with 110 articles identified as having a dyadic focus. While no articles included a specific definition for the dyad, 33 (30%) contained a descriptive reference to the birthing person-infant dyad. Thematic analysis revealed eight recurring elements characteristic of the dyad: (1) engagement, (2) communication, (3) bonding, (4) attachment, (5) mutual responsiveness, (6) reciprocity, (7) synchrony, and (8) attunement. Integrating these elements revealed the interactional relationship between the opioid-exposed birthing person and infant as the foundational principle that defines the dyad.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>This definition shifts the focus of the opioid-exposed dyad from two individual patient populations to an interactional relationship that has broad applicability for clinical use, public health data collection, and research considerations.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fped.2024.1349102","type":"journal-article","created":{"date-parts":[[2024,5,7]],"date-time":"2024-05-07T04:32:22Z","timestamp":1715056342000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["Clinically defining the opioid-exposed birthing person and infant as a dyad to support bedside care, surveillance, and research"],"prefix":"10.3389","volume":"12","author":[{"given":"Shahla M.","family":"Jilani","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan M.","family":"Davis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Goldstein","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Grossman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lauren M.","family":"Jansson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mishka","family":"Terplan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hendr\u00e9e E.","family":"Jones","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2024,5,7]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"146","DOI":"10.1001\/jama.2020.24991","article-title":"Neonatal abstinence syndrome and maternal opioid-related diagnoses in the US, 2010\u20132017","volume":"325","author":"Hirai","year":"2021","journal-title":"JAMA"},{"key":"B2","doi-asserted-by":"publisher","first-page":"e2013456","DOI":"10.1001\/jamanetworkopen.2020.13456","article-title":"Association of pregnancy and insurance status with treatment access for opioid use disorder","volume":"3","author":"Patrick","year":"2020","journal-title":"JAMA Netw Open"},{"key":"B3","doi-asserted-by":"publisher","first-page":"356","DOI":"10.1080\/08897077.2018.1488336","article-title":"Barriers to accessing treatment for pregnant women with opioid use disorder in Appalachian States","volume":"40","author":"Patrick","year":"2019","journal-title":"Subst Abus"},{"key":"B4","doi-asserted-by":"publisher","first-page":"107652","DOI":"10.1016\/j.drugalcdep.2019.107652","article-title":"Treatment for substance use disorders in pregnant women: motivators and barriers","volume":"205","author":"Frazer","year":"2019","journal-title":"Drug Alcohol Depend"},{"key":"B5","doi-asserted-by":"publisher","first-page":"466","DOI":"10.1097\/AOG.0000000000002734","article-title":"Fatal and nonfatal overdose among pregnant and postpartum women in Massachusetts","volume":"132","author":"Schiff","year":"2018","journal-title":"Obstet Gynecol"},{"key":"B6","doi-asserted-by":"publisher","first-page":"2033","DOI":"10.1056\/NEJMoa2203318","article-title":"Buprenorphine versus methadone for opioid use disorder in pregnancy","volume":"387","author":"Suarez","year":"2022","journal-title":"N Engl J Med"},{"key":"B7","doi-asserted-by":"publisher","first-page":"e20164070","DOI":"10.1542\/peds.2016-4070","article-title":"A public health response to opioid use in pregnancy","volume":"139","author":"Patrick","year":"2017","journal-title":"Pediatrics"},{"key":"B8","doi-asserted-by":"publisher","first-page":"e2020029074","DOI":"10.1542\/peds.2020-029074","article-title":"Neonatal opioid withdrawal syndrome","volume":"146","author":"Patrick","year":"2020","journal-title":"Pediatrics"},{"key":"B9","volume-title":"Clinical Guidance for Treating Pregnant and Parenting Women with Opioid use Disorder and their Infants","year":"2018"},{"key":"B10","doi-asserted-by":"publisher","first-page":"178","DOI":"10.1097\/ADM.0000000000000308","article-title":"Treating women who are pregnant and parenting for opioid use disorder and the concurrent care of their infants and children: literature to support national guidance","volume":"11","author":"Klaman","year":"2017","journal-title":"J Addict Med"},{"key":"B11","article-title":"Ego distortion in terms of true and false self","volume-title":"The Maturational Processes and the Facilitating Environment-Studies in the Theory of Emotional Development","author":"Winnicott","year":"1960"},{"key":"B12","volume-title":"Attachment and Loss: Vol. 1. 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