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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
19:15

Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale

Published on: August 25, 2014

Treatment of neonatal abstinence syndrome

K Johnson1, C Gerada, A Greenough

  • 1Children Nationwide Regional Neonatal Intensive Care Centre, Department of Child Health, King's College Hospital, London SE5 9RS, UK. kathryn.2.johnson@kcl.ac.uk

Archives of Disease in Childhood. Fetal and Neonatal Edition
|December 24, 2002
PubMed

Insights

Neonatal abstinence syndrome (NAS) treatment requires more research. Opioids show promise for NAS infants, but optimal drug choice and regimen remain undetermined.

Area of Science:

  • Neonatal Abstinence Syndrome (NAS) research
  • Pediatric pharmacology
  • Substance withdrawal in newborns

Background:

  • Neonatal Abstinence Syndrome (NAS) affects infants experiencing withdrawal from substances due to in utero exposure.
  • Affected infants often require extended hospitalization and treatment.
  • Current treatment options for NAS have limited evidence supporting their efficacy.

Purpose of the Study:

  • To review the current evidence on drug efficacy for treating Neonatal Abstinence Syndrome (NAS).
  • To identify gaps in research regarding optimal pharmacotherapy for NAS.
  • To evaluate the effectiveness of different drug classes and regimens for NAS management.

Main Methods:

  • Systematic review of randomized controlled trials (RCTs) and comparative studies on NAS pharmacotherapy.
  • Analysis of evidence for opioid versus non-opioid treatments.
  • Comparison of different opioid agents and combination therapies.

Main Results:

  • Opioids are suggested as the most appropriate treatment for NAS, particularly for infants exposed to diamorphine or methadone.
  • Diazepam has demonstrated ineffectiveness in head-to-head trials for NAS.
  • Morphine and methadone are common, but comparative efficacy data from RCTs are lacking.
  • Efficacy of single-agent versus multi-drug regimens for poly-substance exposed infants requires further investigation.

Conclusions:

  • Further research, including randomized trials, is essential to determine the most beneficial opioid and optimal treatment strategy for Neonatal Abstinence Syndrome.
  • Evidence supports opioids over other agents like diazepam for NAS, but comparative data between morphine and methadone is needed.
  • The best approach for infants exposed to multiple substances in utero remains an open question requiring dedicated research.

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