Validation of the Finnegan Neonatal Abstinence Syndrome Tool–Short Form

Maguire, David; Cline, Genieveve J.; Parnell, Lisa; Tai, Chun‐Yi

doi:10.1097/anc.0000000000000033

Cited by 50 publications

(34 citation statements)

References 16 publications

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“…70,96 Shortened or simplified versions of these scores have met with little success. 128,129 Quantifying the severity of NAS assists in determining if and when pharmacological intervention will be needed. Scoring also assists in monitoring, titrating, and terminating therapy.…”

Section: Managementmentioning

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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Section: Managementmentioning

confidence: 99%

Neonatal Abstinence Syndrome

2014

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“…Several simplified Finnegan-based scoring tools have been developed. 27,30,32,33 The 10-item simplified Finnegan Neonatal Abstinence Scoring System (sFNAST), 33 published in 2017, included 7 of 8 items in the scale proposed in this study (ie, tremors, increased muscle tone, poor sleep, tachypnea, excessive sucking, poor feeding, and feeding intolerance). This overlap is notable considering the differences in method for deriving the scores.…”

Section: Discussionmentioning

confidence: 99%

Association of a Simplified Finnegan Neonatal Abstinence Scoring Tool With the Need for Pharmacologic Treatment for Neonatal Abstinence Syndrome

et al. 2020

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IMPORTANCE Observer-rated scales, such as the Finnegan Neonatal Abstinence Scoring Tool (FNAST), are used to quantify the severity of neonatal abstinence syndrome (NAS) and guide pharmacologic therapy. The FNAST, a comprehensive 21-item assessment tool, was developed for research and subsequently integrated into clinical practice; a simpler tool, designed to account for clinically meaningful outcomes, is urgently needed to standardize assessment. OBJECTIVES To identify FNAST items independently associated with the decision to use pharmacologic therapy and to simplify the FNAST while minimizing loss of information for the treatment decision. DESIGN, SETTING, AND PARTICIPANTS This multisite cohort study included 424 neonates with opioid exposure who had a gestational age of at least 36 weeks with follow-up from birth to hospital discharge in the derivation cohort and 109 neonates with opioid exposure from the Maternal Opioid Treatment: Human Experimental Research Study in the validation cohort. Neonates in the derivation cohort were included in a medical record review at the Universities of Louisville and Kentucky or in a randomized clinical trial and observational study conducted at Tufts University (2014-2018); the

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“…NAS assessment by modified Finnegan scale was performed every 3 to 4 hours by trained medical staff for all infants. 22 These scores were charted and collected from electronic medical records. Per unit protocol, MSO 4 was initiated at a starting dose of 0.05 mg/kg/dose if the infant had two consecutive scores of !…”

Section: Methodsmentioning

confidence: 99%

Effects of Partially Hydrolyzed Formula on Severity and Outcomes of Neonatal Abstinence Syndrome

et al. 2019

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Objective This article compares the effect of partially hydrolyzed formula (PHF) and standard formula (SF) on the severity and short-term outcomes of neonatal abstinence syndrome (NAS). Study Design We performed a retrospective chart review of 124 opioid-dependent mothers and their term or near-term infants. Infants were categorized according to the predominant type of formula consumed during the hospital stay. Finnegan's scale was used to assess symptoms of withdrawal. Results A total of 110 infants met our inclusion criteria. Thirty-four (31%) infants were fed predominantly PHF, 60 (54%) infants were fed SF, and 16 (15%) infants were fed maternal breast milk. There was no difference between the infants in the PHF and SF groups with respect to requirement of morphine (MSO4) therapy, maximum dose of MSO4 used, duration of MSO4 treatment or length of hospital stay after performing multivariate analyses to control for type of drug used by the mother, maternal smoking, regular prenatal care, inborn status, and maximum Finnegan score prior to MSO4 treatment. Conclusion Use of PHF failed to impact short-term outcomes in infants treated for NAS including maximum MSO4 dose, duration of MSO4 treatment, and length of hospital stay. A prospective randomized controlled trial may be indicated to confirm this finding.

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Validation of the Finnegan Neonatal Abstinence Syndrome Tool–Short Form

Cited by 50 publications

References 16 publications

Neonatal Abstinence Syndrome

Neonatal Abstinence Syndrome

Association of a Simplified Finnegan Neonatal Abstinence Scoring Tool With the Need for Pharmacologic Treatment for Neonatal Abstinence Syndrome

Effects of Partially Hydrolyzed Formula on Severity and Outcomes of Neonatal Abstinence Syndrome

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