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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
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Morphine versus clonidine for neonatal abstinence syndrome
Henrietta S Bada1, Thitinart Sithisarn2, Julia Gibson3
1Departments of Pediatrics, College of Medicine, hbada2@uky.edu.
Pediatrics
|January 28, 2015
Summary
Clonidine treatment for neonatal abstinence syndrome (NAS) showed improved neurobehavioral scores compared to morphine. Clonidine offers a potentially better alternative for NAS management, warranting further research.
Area of Science:
- Neonatal care
- Pharmacology
- Neuroscience
Background:
- Neonatal Abstinence Syndrome (NAS) is a significant concern in newborns exposed to substances in utero.
- Current treatments often involve opioids like morphine, which can have long-term neurobehavioral effects.
- Exploring alternative pharmacotherapies for NAS is crucial for improving infant outcomes.
Purpose of the Study:
- To compare the efficacy of clonidine versus morphine in treating neonatal abstinence syndrome (NAS).
- To evaluate the neurobehavioral performance of infants treated with clonidine compared to morphine.
- To assess long-term developmental outcomes at 1-year adjusted age.
Main Methods:
- Pilot study randomizing infants (≥35 weeks gestational age) to receive either morphine or clonidine for NAS treatment.
- Dose escalation and tapering protocols were followed based on symptom severity.
- Neurobehavioral assessments included the NICU Network Neurobehavioral Scale (NNNS), Bayley Scales III, and Preschool Language Scale IV.
Main Results:
- Clonidine treatment duration was significantly shorter than morphine (28 vs. 39 days).
- Infants receiving clonidine demonstrated significant improvements in NNNS scores and showed reduced arousal and excitability.
- No significant differences were observed in 1-year motor, cognitive, or language scores between the groups.
Conclusions:
- Clonidine presents a promising alternative monotherapy for neonatal abstinence syndrome (NAS).
- The findings suggest potential neurobehavioral benefits of clonidine over morphine.
- A multicenter randomized trial is recommended to confirm these results.
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