G135(P) Chasing the welsh dragon: a review of the outcome of infants with neonatal abstinence syndrome over a 10 year period

Abstract

Introduction Neonatal abstinence syndrome (NAS) is a complex, multi system disorder which not only involves acute withdrawal, but also long term morbidities. We looked at infants with NAS at the Royal Gwent Hospital (RGH), and studied the impact of the condition on their health over a 10 year period. Methods Infants born in RGH with a diagnosis of NAS between 2000 – 2010 were identified from the neonatal and transitional care admission registers. Clinical work station documents plus the neonatal database were used to gather information. Results The total number of infants with a diagnosis of NAS was 231; 101 were admitted to the neonatal unit. 83% of babies had urine toxicology performed and the commonest result was methadone plus opiates (26%). Of the babies admitted to the unit, the average duration of stay was 20 days and all required pharmacological management. In our cohort, 15% developed ophthalmological disorders, including squint, nystagmus and delayed visual maturation; 13% had developmental problems and 44% of these showed speech and language delay. 43% of the 231 infants attended AE head injury was common. Conclusion The incidence of NAS inSouth Gwentin the decade 2000 to 2010 is around 8/1000 live births. Approximately 1 in 7 infants develop ophthalmological disorders and 1 in 8 have developmental problems. We conclude that infants with NAS in the neonatal period have significant ongoing morbidity and remain a vulnerable group who may benefit from enhanced targeted health surveillance.