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Neonatal withdrawal from maternal volatile substance abuse
M Tenenbein1, O G Casiro, M M Seshia
1Department of Pediatrics, University of Manitoba, Winnipeg, Canada.
Summary
Neonates born to mothers abusing volatile substances may develop an abstinence syndrome. A characteristic chemical odor in the infant or mother can indicate risk, and phenobarbital treatment appears effective.
Area of Science:
- Neonatal Abstinence Syndrome
- Substance Abuse in Pregnancy
- Perinatal Health
Background:
- Maternal volatile substance abuse poses risks to neonates.
- Neonatal abstinence syndrome (NAS) requires identification and management.
- Limited data exists on volatile substance abuse and neonatal outcomes.
Purpose of the Study:
- To investigate the risk of abstinence syndrome in neonates exposed to volatile substances in utero.
- To identify clinical markers and effective treatments for neonatal abstinence syndrome due to volatile substance abuse.
Main Methods:
- A prospective study of infants born to mothers with volatile substance abuse.
- Utilized the Finnegan Neonatal Abstinence Scoring System for clinical assessment.
- Administered phenobarbital for treatment of confirmed cases.
Main Results:
- 32 out of 48 neonates required pharmacotherapy for abstinence syndrome.
- A characteristic chemical odor was associated with higher incidence of NAS.
- Phenobarbital treatment was effective in 17 out of 27 infants, with borderline benefit in 3 and no benefit in 7.
Conclusions:
- An identifiable neonatal volatile substance abuse abstinence syndrome exists.
- Maternal or neonatal chemical odor is a significant marker for NAS.
- Phenobarbital is an effective treatment, and the Finnegan Scoring System aids in severity assessment.