Neonatal Abstinence Syndrome: A Case Series

Area of Science:

• Neonatology
• Public Health

Background:

• Substance misuse is increasing globally, impacting maternal and infant health.
• Neonatal Abstinence Syndrome (NAS) is a growing concern, particularly in regions with limited published data like India.
• Diagnosis of NAS is often complicated by nonspecific symptoms and maternal history concealment.

Observation:

• A case series of three Indian newborns presenting with classic NAS symptoms: restlessness, high-pitched crying, sweating, tremors, and diarrhea.
• Maternal substance use history was initially suppressed in two out of three cases, delaying diagnosis.
• One mother used psychotropic medications (SSRIs, atypical antipsychotics, tricyclic antidepressants); another had nicotine addiction; the third had opiate addiction.

Findings:

• Despite diagnostic challenges, all three cases were diagnosed with NAS.
• Treatment with phenobarbitone proved effective in managing the withdrawal symptoms in all neonates.
• Successful management and discharge were achieved for all infants in the case series.

Implications:

• Highlights the need for increased awareness and improved diagnostic strategies for NAS in India.
• Emphasizes the importance of addressing maternal substance misuse to prevent NAS.
• Phenobarbitone is confirmed as an effective treatment option for NAS in the Indian context.