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Semin Fetal Neonatal Med. 2019 Apr;24(2):133-141. doi: 10.1016/j.siny.2019.01.009. Epub 2019 Feb 5.

Pharmacological and non-pharmacological treatments for the Neonatal Abstinence Syndrome (NAS).

Author information

1
Faculty of Science, University of Alberta, Edmonton, Alberta, Canada; Centre for the Studies of Asphyxia and Resuscitation, Neonatal Research Unit, Royal Alexandra Hospital, Edmonton, Alberta, Canada.
2
Centre for the Studies of Asphyxia and Resuscitation, Neonatal Research Unit, Royal Alexandra Hospital, Edmonton, Alberta, Canada; Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada. Electronic address: georg.schmoelzer@me.com.
3
Department of Pharmacology and Experimental Therapeutics, Thomas Jefferson University, Philadelphia, PA, USA.

Abstract

Neonatal abstinence syndrome is defined by signs and symptoms of withdrawal that infants develop after intrauterine maternal drug exposure. All infants with documented in utero opioid exposure, or a high pre-test probability of exposure should have monitoring with a standard assessment instrument such as a Finnegan Score. A Finnegan score of >8 is suggestive of opioid exposure, even in the absence of declared use during pregnancy. At least half of infants in most locales can be treated without the use of pharmacologic means. For this reason, symptom scores will drive the decision for pharmacologic therapy. Nevertheless, all infants, regardless of initial manifestations, should be first be managed with non-pharmacologic approaches which in turn, should not be considered as the sole alternative to drug therapy, but rather, as the base upon which all patients are treated. Those who continue to have symptoms despite supportive care should be pharmacologically treated, which in the most severe cases, is life-saving.

KEYWORDS:

Infant; Neonatal abstience syndrome; Opioid

PMID:
30745219
PMCID:
PMC6451887
[Available on 2020-04-01]
DOI:
10.1016/j.siny.2019.01.009

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