Neonatal Abstinence Syndrome Among Infants Born to Mothers With Sickle Cell Hemoglobinopathies [3R

Abstract

INTRODUCTION: The objective of this study is to examine risk factors for neonatal abstinence syndrome (NAS) among infants born to mothers with sickle cell hemoglobinopathies (SCH). METHODS: This is a retrospective case-control study of non-anomalous, singleton infants born to mothers with laboratory confirmed SCH and placental pathology results. Infants were included if they were diagnosed with NAS prior to hospital discharge. The outcome of interest was the association of maternal variables with NAS. RESULTS: The occurrence of NAS was 4% (n=5). Mothers with NAS were more likely to have SC disease (80%) compared to other SCH (20%). Mean weeks gestational age (wga) at delivery was 37 ± 2; and did not differ among NAS affected infants compared to infants without NAS (p=0.51). Likewise, the infant's hospital length of stay (LOS) did not differ between infants with NAS (11 ± 4 days) compared to unaffected infants (8 ± 18 days), p=0.3. A preterm birth rate of 21% associated with prolonged NICU admissions may contribute to similar neonatal LOS. Fifteen women had antepartum (AP) admissions for pain and/or sickle crisis. Of these patients, 4 infants (29%) were diagnosed with NAS. The median maternal AP LOS for women with infants diagnosed with NAS was 132 (61, 164) days compared to women who were admitted for pain but whose infants were not diagnosed infants with NAS: 7.5 (4, 12) days (p < 0.001). CONCLUSION: Incidence of NAS among mothers with sickle cell hemoglobinopathies is low; severe disease requiring prolonged AP admission for pain control significantly increases the risk of NAS.