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Published on: August 25, 2014
Neonatal abstinence syndrome: a case series from Colombo-Sri Lanka
Sangeetha Wickramaratne1,2, Udara Sandakelum3, Hashan Pathiraja4,3
1Faculty of Medicine, University of Kelaniya, Kelaniya, Sri Lanka. shyamiw@kln.ac.lk.
BMC Pediatrics
|July 7, 2026
Summary
Neonatal Abstinence Syndrome (NAS) is a growing problem, especially among young mothers. Managing NAS in resource-limited areas presents significant healthcare challenges, including prolonged hospital stays and complex withdrawal symptoms.
Area of Science:
- Neonatology
- Public Health
- Pharmacology
Background:
- Neonatal Abstinence Syndrome (NAS) is a significant global health concern linked to increased maternal substance use during pregnancy.
- Underreporting of NAS is common due to non-specific symptoms and limited toxicological testing access.
- This study examines NAS management complexities in a resource-limited environment.
Purpose of the Study:
- To explore the clinical complexities of Neonatal Abstinence Syndrome (NAS) management.
- To identify systemic hurdles in treating NAS within a resource-limited setting.
- To report on substance abuse patterns among pregnant women and their impact on neonates.
Main Methods:
- A case series review of 23 neonates diagnosed with NAS across two Sri Lankan neonatal care centers over 18 months.
- Clinical data collection focusing on maternal demographics, substance use disclosure, antenatal care, and neonatal symptoms.
- Utilized the Modified Finnegan Score for guiding therapy, with 17 infants receiving pharmacological treatment.
Main Results:
- The majority of mothers (70%) were under 25 years old, with 86.9% disclosing substance use and 100% having poor antenatal care.
- Twenty-one out of 23 neonates exhibited symptoms, with all symptomatic infants presenting neurological manifestations like irritability and tremors.
- Seventeen infants required pharmacological intervention, primarily oral morphine, for NAS management.
Conclusions:
- Highlights a concerning trend of substance abuse among women under 25 years old.
- Underscores the significant strain NAS management places on healthcare systems due to prolonged hospitalizations and complex withdrawal needs.
- Emphasizes the need for improved strategies to address NAS in resource-limited settings.
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