This study was designed to compare the safety and efficacy of morphine and methadone for treating NAS. A randomized, double-blind study was conducted at The Children’s Hospital & The Institute of Child Health Multan from December 2021 to December 2022. A total of 180 pregnant women were enrolled in the study, of which 114 needed treatment and were randomized (1:1) to receive morphine or methadone. Standardized Finnegan Score (FS)was used to assess infants every four hours. Methadone alternating with placebo or neonatal diluted morphine was administered to infants every four hours. The primary endpoint of the study was the duration of the hospital stay. Both the methadone and morphine groups had similar risk factors and demographic variables. There was a total of 14 adverse events equally distributed in both groups. After adjusting for the type of opioid used by the mother, it wasfound that the mean relative duration of hospital stay was 13% (which corresponds to the difference of 2.8 days) lower in the methadone group compared to morphine. The duration of treatment was 15% (which corresponds to a difference of 2.2 days) lower in the methadone group than in morphine. The median hospital stay with methadone was 15 days compared to 19 days with morphine (P = .005). Based on the results, it can be concluded that for the treatment of NAS, methadone had better short-term outcomes than morphine

The retrospective study was conducted in the Peadiatrics Department of Nishter Medical Hospital & CH & ICH Multan from January 2010 to January 2020 to evaluate major morbidity and survival rate in extremely preterm infants. A total of 9095 infants were included in the study. The study participants were divided into 2 groups. Group I included infants who survived for less than 1 day, and Group II included infants who survived for more than 1 day. Detailed information regarding infant and maternal characteristics, birth certificates, prenatal care, antenatal conditions, death records, and all maternal and infant record from a year before to a year after birth was derived from the database of the hospital. Results show that infants born at 22-24 weeks had neonatal morbidities, including retinopathy of prematurity, sepsis, bronchopulmonary dysplasia, necrotizing enterocolitis, periventricular leukomalacia or grade III or IV IVH (Table I). 9% (818 infants) of survivors had grade III or IV intraventricular hemorrhage, and 3% (273 infants) had PVL, infants born at 22nd to 23rd weeks were at higher risk of developing these complications. Almost 80% of infants born at 22-25 weeks gestation suffered from at least one major morbidity. The 1-year survival rate of infants born at 22, 23, and 24 weeks was 5.9%, 27%, and 59.9%, respectively. It is concluded that less than half of the infants born at the lowest gestational ages (22 and 23 weeks) survive after resuscitation, and two-thirds have more than 1 major morbidity.