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Updated: Jun 20, 2026

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

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Published on: August 25, 2014

Prenatal methadone exposure and neonatal neurobehavioral functioning.

Martha L Velez1, Lauren M Jansson, Jennifer Schroeder

  • 1Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland 21224, USA.

Pediatric Research
|August 20, 2009
PubMed
Summary

Prenatal methadone exposure impacts infant neurobehavior, with Neonatal Abstinence Syndrome (NAS) severity correlating to dysregulated behavior. The NICU Network Neurobehavioral Scale (NNNS) helps assess these infants, guiding treatment for all exposed newborns.

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Published on: March 6, 2018

Area of Science:

  • Neonatal development
  • Neuroscience
  • Pharmacology

Background:

  • Prenatal opioid exposure, particularly to methadone, leads to varied neurobehavioral dysregulation in infants.
  • Neonatal Abstinence Syndrome (NAS) is recognized, but subtler regulatory difficulties outside defined NAS clusters are less understood.
  • These subtle difficulties may significantly impact long-term infant development.

Purpose of the Study:

  • To describe the neurobehavioral functioning of neonates with prenatal methadone exposure using the NICU Network Neurobehavioral Scale (NNNS).
  • To explore associations between maternal factors and infant neurobehavioral outcomes.
  • To evaluate the relationship between NNNS measures, NAS severity, and the need for pharmacotherapy.

Main Methods:

  • Utilized the NICU Network Neurobehavioral Scale (NNNS) to assess neurobehavioral functioning in methadone-exposed neonates.
  • Collected data on maternal factors and methadone dosage.
  • Correlated NNNS scores with NAS severity and pharmacotherapy requirements.

Main Results:

  • Infants requiring pharmacologic treatment for NAS exhibited more dysregulated behavior, stress, and abstinence signs via NNNS scores.
  • NNNS scores did not show a significant correlation with maternal methadone dose.
  • A spectrum of neurobehavioral functioning exists in methadone-exposed infants beyond severe NAS.

Conclusions:

  • The NNNS provides valuable insights into the neurobehavioral repertoire of methadone-exposed infants.
  • Understanding this range is crucial for optimizing treatment, including non-pharmacologic care for infants not meeting severe NAS criteria.
  • Further research can refine interventions for all infants affected by prenatal methadone exposure.