Prise en charge du syndrome de sevrage du nouveau-né de mère toxicomane aux opiacés : enquête française et européenne

Abstract

Maternal opioid abuse during pregnancy results in 60 to 95% of neonatal withdrawal. The literature review on the evaluation of the severity of the related symptoms and treatments used shows an absence of consensus. Materials and methods. – To survey the management of the neonatal withdrawal a questionnaire was sent to French and other European pharmacists. Results. – Fifty-eight questionnaires were returned, 37 from France. In 74%, a written protocol about the management of the neonatal withdrawal was available. The severity of the symptoms was assessed using the Finnegan ‘s scale in 55% of the cases and the treatment was a substitute opiate in 72.5%. In 64% of the cases, this drug was an oral morphine solution: a hydrochloride solution in France and a sulfate solution in other E.U countries at the most common dose of 0.5 to 1mg kg –1d –1 and 0.24mg kg –1 d –1 respectively. Discussion. – The solution used in France is contra-indicated in infants less than six months and the presentation is not adapted to this use. Conclusion. – This morphine survey points out that a preparation intended for infants should be developed and licensed in this indication to improve the use of treatment.