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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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Prenatal buprenorphine exposure and neonatal neurobehavioral functioning
Martha L Velez1, Krystle McConnell1, Nancy Spencer2
1Johns Hopkins University School of Medicine, Department of Pediatrics, United States.
Early Human Development
|December 11, 2017
Summary
Prenatal buprenorphine exposure impacts infant neurobehavior. Higher maternal doses correlated with increased infant stress and need for neonatal abstinence syndrome (NAS) treatment, highlighting the need for comprehensive assessments beyond NAS.
Area of Science:
- Neonatal neurobehavioral functioning
- Prenatal substance exposure effects
- Opioid use disorder in pregnancy
Background:
- Neonatal Abstinence Syndrome (NAS) evaluations primarily focus on pharmacotherapy needs.
- Comprehensive assessment of neurobehavioral functioning in infants exposed to opioids prenatally is crucial.
- Maternal substance use and psychosocial factors influence infant neurobehavioral outcomes.
Purpose of the Study:
- To comprehensively evaluate the effects of gestational maternal buprenorphine maintenance on newborn neurobehavioral functioning.
- To explore maternal substance use history and psychosocial demographics impacting infant neurobehavior.
- To assess infant neurologic and behavioral functioning using the NICU Network Neurobehavioral Scale (NNNS).
Main Methods:
- Study included 41 pregnant women on buprenorphine maintenance and their infants.
- Infants were assessed using the NNNS on days 3, 14, and 30 of life.
- Maternal buprenorphine dose at delivery and infant pharmacotherapy requirements for NAS were recorded.
Main Results:
- Higher maternal buprenorphine dose correlated with poorer infant quality of movement, self-regulation, and increased CNS stress/abstinence signs at day 3.
- Increased maternal buprenorphine dose was associated with a higher morphine dose requirement for infant NAS treatment.
- No significant differences in NNNS domain scores were found between infants requiring pharmacotherapy for NAS and those who did not at day 3.
Conclusions:
- Prenatal buprenorphine exposure can alter neonatal neurobehavioral and physiological responses.
- Systematic evaluation beyond NAS assessment is vital for addressing neurobehavioral dysregulation.
- Comprehensive maternal treatment supports healthier outcomes for the mother-infant dyad.
