Predicting length of treatment for neonatal abstinence syndrome in methadone-exposed neonates

Seligman, Neil S.; Salva, Nicole; Hayes, Edward J.; Dysart, Kevin; Pequignot, Edward; Baxter, Jason K.

doi:10.1016/j.ajog.2008.06.088

Cited by 114 publications

(96 citation statements)

References 25 publications

(13 reference statements)

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“…Buprenorphine has been used in critically ill preterm infants, 15 but its utility in preterm infants with the neonatal abstinence syndrome has not been defined. Preterm infants have a decreased incidence and severity of withdrawal signs, [16][17][18] and it is unclear whether the standard scoring instruments that we used would be valid in this population. Exposure to benzodiazepines in utero is associated with worsened symptoms of neonatal abstinence.…”

Section: Discussionmentioning

confidence: 99%

Buprenorphine for the Treatment of the Neonatal Abstinence Syndrome

Kraft

Adeniyi-Jones

Chervoneva³

et al. 2017

Obstetrical &Amp; Gynecological Survey

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Section: Discussionmentioning

confidence: 99%

Buprenorphine for the Treatment of the Neonatal Abstinence Syndrome

Kraft

Adeniyi-Jones

Chervoneva³

et al. 2017

Obstetrical &Amp; Gynecological Survey

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“…[97][98][99] Of the opioids, heroin exposure causes earlier and shorter withdrawal, whereas methadone and buprenorphine exposure lead to later onset and longer withdrawal. Of the nonopioids, methamphetamines cause immediate withdrawal,psychotropicmedicationsusually induce transitional and self-limiting withdrawal, and the results are indeterminate for benzodizepines.…”

Section: Clinical Presentationmentioning

confidence: 99%

“…Of the nonopioids, methamphetamines cause immediate withdrawal,psychotropicmedicationsusually induce transitional and self-limiting withdrawal, and the results are indeterminate for benzodizepines. [96][97][98][99][100] Table 1 summarizes the onset, duration, and frequency of NAS caused by various substances.…”

Section: Clinical Presentationmentioning

confidence: 99%

Neonatal Abstinence Syndrome

2014

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Neonatal abstinence syndrome (NAS) is a result of the sudden discontinuation of fetal exposure to substances that were used or abused by the mother during pregnancy. Withdrawal from licit or illicit substances is becoming more common among neonates in both developed and developing countries. NAS continues to be an important clinical entity throughout much of the world. NAS leads to a constellation of signs and symptoms involving multiple systems. The pathophysiology of NAS is not completely understood. Urine or meconium confirmation may assist the diagnosis and management of NAS. The Finnegan scoring system is commonly used to assess the severity of NAS; scoring can be helpful for initiating, monitoring, and terminating treatment in neonates. Nonpharmacological care is the initial treatment option, and pharmacological treatment is required if an improvement is not observed after nonpharmacological measures or if the infant develops severe withdrawal. Morphine is the most commonly used drug in the treatment of NAS secondary to opioids. An algorithmic approach to the management of infants with NAS is suggested. Breastfeeding is not contraindicated in NAS, unless the mother is taking street drugs, is involved in polydrug abuse, or is infected with HIV. Future studies are required to assess the long-term effects of NAS on children after prenatal exposure.

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“…Phy-sicians need to be more aware of this problem before prescribing benzodiazepines and to have a heightened awareness of psychiatric comorbidities, which often foster concomitant benzodiazepine abuse [49] . Additional significant problems for pregnant opioid-dependent women lie not only in the teratogenic potential of benzodiazepines [50] , but also in the possibly prolonged and more severe manifestation of symptoms of the neonatal abstinence syndrome [51] . Third, in the USA, opioid-dependent pregnant women should be screened, assessed, and assisted in legal and financial issues which impair their access to healthcare.…”

Section: Discussionmentioning

confidence: 99%

Clinical Characteristics of Central European and North American Samples of Pregnant Women Screened for Opioid Agonist Treatment

et al. 2010

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Background: Little comparable information is available regarding clinical characteristics of opioid-dependent women from different countries. In the present study, women from the USA, Canada and a Central European country, Austria, screened for participation in the Maternal Opioid Treatment Human Experimental Research study, were compared with respect to their demographic and addiction histories. Methods: Pregnant women (n = 1,074) were screened for study participation using uniformed clinical criteria and instruments. The screening results were compared with regard to exclusion, demographics, drug use, and psychosocial and treatment histories. Results: Compared to the screened US and Canadian women, Austrian women were more likely to be younger (p < 0.001), white (p < 0.001), had significantly lower levels of educational attainment (p < 0.001), were less likely to use opioids daily (p < 0.001) and more likely to have been prescribed buprenorphine (p < 0.001). Compared to both rural and urban US groups, the Austrian group was less likely to have legal issues (p < 0.001) and was younger when first prescribed agonist medication (p < 0.001). Conclusion: The differences between North American and European groups may offer unique insights concerning treatment and pregnancy outcomes for opioid-dependent pregnant women.

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Predicting length of treatment for neonatal abstinence syndrome in methadone-exposed neonates

Cited by 114 publications

References 25 publications

Buprenorphine for the Treatment of the Neonatal Abstinence Syndrome

Buprenorphine for the Treatment of the Neonatal Abstinence Syndrome

Neonatal Abstinence Syndrome

Clinical Characteristics of Central European and North American Samples of Pregnant Women Screened for Opioid Agonist Treatment

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