Retrospective chart review comparing morphine and methadone in neonates treated for neonatal abstinence syndrome

Abstract Objective Newborns exposed to drugs in utero are at risk of developing neonatal abstinence syndrome (NAS), characterized by behavioral changes and physiologic instability. Finnegan scoring tool quantifies severity of symptoms and guides treatment. This article evaluates whether time of day and the number of shift hours affects modified Finnegan scores, and the subjective component of these scores. Study Design Institutional review board-approved, retrospective chart review of newborns admitted to neonatal intensive care or transitional nursery from 2011 to 2014. Inclusion criteria: > 35 weeks' gestation, known maternal substance use, positive maternal or newborn urine, or meconium drug screen, NAS treatment. Results A total of 101 charts were evaluated. Mean treatment duration was 31.8 days (standard deviation ±18.3). There was no significant relationship between observer shift hour and high scores (> 8) (p = 0.83). Highest scores occurred in the afternoon, decreased at night (p = 0.03), and throughout admission (p < 0.0001). Weekend and weekday scores were similar (p = 0.4). The objective component of the scores remained similar throughout the day (p = 0.91) and week (p = 0.52). Conclusion Finnegan scores given by nurses were not influenced by shift hour. Time of day did not influence overall high scores or the proportion of objective to total Finnegan score. Inter-rater reliability was maintained regardless of time of day or day of the week.

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Gender Differences in Withdrawing Infants

Global Pediatric Health ◽

10.1177/2333794x18775886 ◽

2018 ◽

Vol 5 ◽

pp. 2333794X1877588 ◽

Cited By ~ 1

Author(s):

Sarah Stevens ◽

Tyler Flaugher ◽

Kaitlynn Hughes ◽

Carson Terwilliger ◽

Jessica Copley ◽

...

Keyword(s):

Gender Differences ◽

Head Circumference ◽

Online Survey ◽

Growth Parameters ◽

Retrospective Chart Review ◽

Neonatal Abstinence Syndrome ◽

Abstinence Syndrome ◽

Long Term Effects ◽

Male And Female ◽

Survey Tool

Objective. To assess gender differences in infants diagnosed with neonatal abstinence syndrome at the Cabell Huntington Hospital in Huntington, West Virginia. Methods. This is a single-site retrospective chart review involving 97 infants born treated for neonatal abstinence syndrome at the Cabell Huntington Hospital between April and December 2015. Data were obtained from electronic medical records using a secure online survey tool designed using Qualtrics. Maternal demographics and drug screenings were collected. Infant information was collected for the first 7 days of life including withdrawal symptoms, treatment, and growth parameters. These data were analyzed based on gender, male (N = 62) and female (N = 35), to assess any gender differences among the infants. Results. No significant differences were found regarding birth weight, length, and gestational age between male and female infants. Differences among the percentage of symptoms experienced were found with females experiencing a greater percentage of symptoms affecting the autonomic nervous system compared with males. Significant differences in head circumference were found in these infants; females were found to have a greater head circumference at time of birth compared with males ( P = .003), whereas at time of discharge head circumference was greater in males than in females ( P = .035). Conclusion. Differences in symptoms, physical characteristics, and methadone treatment were found between male and female infants diagnosed with neonatal abstinence syndrome at the Cabell Huntington Hospital during 2015. Further studies are needed to assess both the short- and long-term effects of antenatal drug abuse.

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Effects of Partially Hydrolyzed Formula on Severity and Outcomes of Neonatal Abstinence Syndrome

American Journal of Perinatology ◽

10.1055/s-0039-1692684 ◽

2019 ◽

Vol 37 (11) ◽

pp. 1177-1182 ◽

Cited By ~ 2

Author(s):

Mahdi Alsaleem ◽

Sara K. Berkelhamer ◽

Gregory E. Wilding ◽

Lorin M. Miller ◽

Anne Marie Reynolds

Keyword(s):

Hospital Stay ◽

Controlled Trial ◽

Length Of Hospital Stay ◽

Retrospective Chart Review ◽

Neonatal Abstinence Syndrome ◽

Abstinence Syndrome ◽

Short Term ◽

Term Infants ◽

Near Term ◽

Hydrolyzed Formula

Abstract Objective This study compares the effect of partially hydrolyzed formula (PHF) and standard formula (SF) on the severity and short-term outcomes of neonatal abstinence syndrome (NAS). Study Design We performed a retrospective chart review of 124 opioid-dependent mothers and their term or near-term infants. Infants were categorized according to the predominant type of formula consumed during the hospital stay. Finnegan's scale was used to assess symptoms of withdrawal. Results A total of 110 infants met our inclusion criteria. Thirty-four (31%) infants were fed predominantly PHF, 60 (54%) infants were fed SF, and 16 (15%) infants were fed maternal breast milk. There was no difference between the infants in the PHF and SF groups with respect to requirement of morphine (MSO4) therapy, maximum dose of MSO4 used, duration of MSO4 treatment or length of hospital stay after performing multivariate analyses to control for type of drug used by the mother, maternal smoking, regular prenatal care, inborn status, and maximum Finnegan score prior to MSO4 treatment. Conclusion Use of PHF failed to impact short-term outcomes in infants treated for NAS including maximum MSO4 dose, duration of MSO4 treatment, and length of hospital stay. A prospective randomized controlled trial may be indicated to confirm this finding.

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