Abstract
Neonatal abstinence syndrome (NAS) due to maternal opioid use affects both term and preterm infants; however, the relationship between gestational age and clinical symptomatology is still poorly understood. In this study, we compared the clinical features and outcomes of NAS in infants admitted to a neonatal intensive care unit (NICU) based on gestational age groups: preterm (32–36 6/7 weeks) and term (37 weeks or older). A retrospective data analysis was conducted using the medical records of infants with a diagnosis of NAS admitted to a regional perinatal center between 2014 and 2020. A modified Finnegan scoring system was used based on three different symptom categories, including Central Nervous System (CNS), Gastrointestinal (GI) and Other. In total, 166 infants with a diagnosis of NAS were included, with 52 (31%) who were preterm and 114 (69%) who were term. The highest NAS score was significantly lower for the preterm group than for the term group. Preterm infants were less likely to require first-line pharmacotherapy with morphine (52% versus 75%) and to experience GI symptoms during their hospitalization. Newer NAS assessment modalities, such as eat, sleep, console (ESC), may overcome the existing challenges of traditional scoring systems, but will require validation in preterm infants.
Highlights
Neonatal abstinence syndrome (NAS) due to maternal opioid use affects both term and preterm infants; the relationship between gestational age and clinical symptomatology is still poorly understood [1,2]
The vast majority of drug exposures consisted of opioid use, which was present in 98% of cases in both groups
Our data suggest that preterm infants with NAS are less likely than their term counterparts to have higher NAS scores, and requiring pharmacological treatment, when measured with conventional scoring methodologies, such as the modified Finnegan scoring (MFS)
Summary
Neonatal abstinence syndrome (NAS) due to maternal opioid use affects both term and preterm infants; the relationship between gestational age and clinical symptomatology is still poorly understood [1,2]. NAS, or NOWS (neonatal opioid withdrawal syndrome), is a multisystemic disorder in newborns caused by the abrupt cessation of exposure to maternal substances in utero. It typically impacts the Central Nervous System (CNS), Gastrointestinal (GI) system and autonomic systems, resulting in clinical signs, such as irritability, poor feeding/suck, yawning, sneezing, tachypnea, fever, sweating, diarrhea, vomiting, tremors and convulsions. The type of substances most often implicated in NAS are opioids, but nicotine, anti-depressants, benzodiazepines, alcohol, methamphetamine and inhalants have been shown to play a role in the disease process [5]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
