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Updated: Mar 22, 2026

Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Association between NNNS-II profiles and pharmacological treatment in infants with prenatal opioid exposure
Macie Donahue1,2, Madison Ramirez Heil1,2, Marie Camerota2,3
1Department of Pediatrics, The Warren Alpert Medical School of Brown University, Providence, RI, USA.
Objective:
Examine whether neonatal neurobehavioral profiles are related to need for pharmacological treatment among infants with prenatal opioid exposure.
Study Design:
Prospective cohort study of 217 infants with need for treatment determined using the Finnegan Neonatal Abstinence Tool (FNAST), Neonatal Withdrawal Inventory (NWI), or Eat Sleep Console (ESC). Neurobehavior was assessed with the NeoNatal Neurobehavioral Scale II (NNNS-II). Latent Profile Analysis (LPA) classified infants into neurobehavioral profiles, and logistic regression assessed the association between NNNS-II profiles and need for treatment.
Results:
A 3-profile LPA solution best fit the NNNS-II data comprised of typical (67%), hyper-aroused (19%) and hypo-aroused groups (15%). Infants with atypical NNNS-II profiles were more likely to receive treatment (OR = 3.45, 95% CI 1.21-9.81) compared to infants with typical profiles (p < 0.05).
Conclusion:
Newborn neurobehavioral profiles may aid in early identification of infants requiring pharmacological treatment for opioid withdrawal, reducing length of stay and healthcare costs.
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