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Area of Science:

  • Neonatal Abstinence Syndrome (NAS)
  • Opioid Exposure in Infants
  • Pediatric Withdrawal Syndromes

Background:

  • Neonatal Abstinence Syndrome (NAS) incidence has risen significantly.
  • A lack of a gold standard definition complicates NAS identification.
  • Variability in definitions impacts clinical, research, and public health settings.

Purpose of the Study:

  • To evaluate how different NAS definitions affect calculated incidence.
  • To assess the accuracy of common NAS definitions in identifying clinical withdrawal.

Main Methods:

  • Retrospective cohort study of opioid-exposed infants.
  • Application of six common clinical and surveillance definitions for NAS.
  • Evaluation of definition accuracy in a single-center population.

Main Results:

  • Incidence of NAS varied widely (17.4% to 52.8%) based on the definition used.
  • 23.1% of infants received a clinical NAS diagnosis.
  • 34.1% received a diagnostic code for NAS at discharge.

Conclusions:

  • Significant variability in NAS incidence was observed using common definitions.
  • A need for a standardized, gold standard definition for NAS is highlighted.
  • Standardization is crucial for consistent clinical care, research, and public health surveillance.