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neonatal abstinence syndrome; neonatal drug withdrawal syndrome

A group of disorders that occur in newborns exposed to drugs causing drug dependence. Etiology: - opioid-exposed infants shortly after birth - concurrent use of psychotropics & opiates during pregnancy may further increased risk [5] Epidemiology: - 1.5 per 1000 hospital births in 1999 - 6.0 per 1000 in 2013 - 0.7 per 1000 in Hawaii - 33.4 per 1000 in West Virginia [3] Clinical manifestations: - neonatal opiate withdrawal - irritability - autonomic dysfunction - gastrointestinal distress Management: - placing child in quiet, dark environment [6] - drug therapy indicated only if initial nonpharmacologic measures fail [6] - treatment with sublingual buprenorphine (every 8 hours) rather than oral morphine (every 4 hours) results in a shorter treatment duration & hospital stay [4]

General

neonatal disorder or disease syndrome

References

  1. Tolia VN et al Increasing Incidence of the Neonatal Abstinence Syndrome in U.S. Neonatal ICUs. N Engl J Med. April 26, 2015 PMID: 25913111 http://www.nejm.org/doi/full/10.1056/NEJMsa1500439
  2. Hamdan AH and Rosenkrantz T eMedicine. Neonatal abstinence syndrome. http://emedicine.medscape.com/article/978763-overview
  3. Ko JY, Patrick SW, Tong VT, Patel R, Lind JN, Barfield WD. Incidence of Neonatal Abstinence Syndrome - 28 States, 1999- 2013. MMWR Morb Mortal Wkly Rep 2016;65:799-802 http://www.cdc.gov/mmwr/volumes/65/wr/mm6531a2.htm
  4. Kraft WK, Adeniyi-Jones SC, Chervoneva I et al Buprenorphine for the Treatment of the Neonatal Abstinence Syndrome. N Engl J Med. May 4, 2017 PMID: 28468518 http://www.nejm.org/doi/full/10.1056/NEJMoa1614835
  5. Huybrechts KF et al Risk of neonatal drug withdrawal after intrauterine co-exposure to opioids and psychotropic medications: cohort study. BMJ 2017;358:j3326 PMID: 28768628 Free PMC Article http://www.bmj.com/content/358/bmj.j3326 - Patrick SW et al Prescribing opioids and psychotropic drugs in pregnancy BMJ 2017;358:j3616 PMID: 28768614 Free PMC Article http://www.bmj.com/content/358/bmj.j3616
  6. NEJM Knowledge + Question of the Week. Oct 16, 2018 https://knowledgeplus.nejm.org/question-of-week/4600/
  7. Kocherlakota P. Neonatal abstinence syndrome. Pediatrics 2014 Aug; 134:e547. PMID: 25070299
  8. Sarkar S, Donn SM. Management of neonatal abstinence syndrome in neonatal intensive care units: a national survey. J Perinatol 2006 Jan 1; 26:15. PMID: 16355103
  9. PubMed Health. Neonatal abstinence syndrome. http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0004566/