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Neonatal abstinance

Hendrée E Jones, Karol Kaltenbach, Tara Benjamin, Elisha M Wachman, Kevin E O'Grady
: The opioid epidemic has brought with it an increasing focus on the incidence of Neonatal Abstinence Syndrome (NAS) (also known as Neonatal Opioid Withdrawal Syndrome) in neonates prenatally exposed to opioids, and recently, in the putative long-term effects of NAS on child development. The purpose of the present paper is three-fold: (1) outline shortcomings regarding the current research relating NAS to child development; (2) propose solutions to minimize these shortcomings; and (3) recommend an alternative conceptual framework to understanding developmental problems in later childhood presumed to be a result of NAS...
October 16, 2018: Journal of Addiction Medicine
L Marcellus
AIM: To describe the current state of evidence on the care of neonates with neonatal abstinence syndrome in countries with low to virtually no medical opioid analgesic consumption. BACKGROUND: While access to opioids for medical use improves globally, misuse grows as a health concern. One unintended consequence has been an increase in the incidence of neonatal abstinence syndrome. Because most evidence is generated in countries with adequate opioid analgesic consumption, a picture of evidence in lower opioid-consuming countries is not available...
October 14, 2018: International Nursing Review
Amna Umer, Sean Loudin, Stefan Maxwell, Christa Lilly, Meagan E Stabler, Lesley Cottrell, Candice Hamilton, Janine Breyel, Christina Mullins, Collin John
BACKGROUND: Neonatal abstinence syndrome (NAS) is one of the consequences at birth affecting the newborn after discontinuation of prenatal drug exposure to mainly opioids. The objective of this study was to determine the extent of the problem in the state of West Virginia (WV) using a real-time statewide surveillance system. METHODS: Project WATCH is a surveillance tool that since 1998 collects data on all infants born in the state of WV. NAS surveillance item was added to the tool in October 2016...
October 4, 2018: Pediatric Research
Jessica J Walker, Martin E Olsen
OBJECTIVES: This study was undertaken to confirm that patient reports on buprenorphine medication - assisted therapy in for-profit buprenorphine clinics in our community were personally costly. We contacted all 17 for-profit clinics in our community and confirmed the patient reports that a significant financial payment of ≤$100 was required for each visit. We also found that tapering of buprenorphine dosage in pregnancy was offered by several of the clinics. METHODS: A telephone survey was conducted with the 17 for-profit buprenorphine clinics located in the Johnson City, Tennessee area...
October 2018: Southern Medical Journal
Qi Guan, Beth A Sproule, Simone N Vigod, Suzanne M Cadarette, Simon Greaves, Diana Martins, Tara Gomes
BACKGROUND AND AIMS: Methadone maintenance therapy (MMT) is associated with improved outcomes for children exposed to maternal opioid dependence in utero. We examined Ontario's population of pregnant women on MMT and determined the impact of timing of MMT initiation on perinatal outcomes. DESIGN: Cohort study. SETTING: Ontario, Canada PARTICIPANTS: Women eligible for public drug benefits and on MMT during pregnancy between 2005-2015. MEASUREMENTS: We stratified women based on their timing of MMT initiation: 1) stabilized prior to conception, 2) newly initiated prior to conception, 3) initiation in trimester one, 4) initiation in trimester two, or 5) initiation in trimester three...
October 1, 2018: Addiction
Guodong Liu, Lan Kong, Douglas L Leslie, Tammy E Corr
OBJECTIVE: To describe healthcare use over time of children with a history of neonatal abstinence syndrome (NAS) compared with children without NAS. STUDY DESIGN: In this retrospective, longitudinal cohort study, data were obtained from MarketScan Commercial Claims and Encounters database from 2005 to 2014. Children with and without NAS based on International Classification of Diseases, Ninth Revision diagnostic codes were followed until 8 years or disenrollment (mean: 35 months)...
September 27, 2018: Journal of Pediatrics
Amy L Lembeck, Deborah Tuttle, Robert Locke, Laura Lawler, Pamela Jimenez, Amy Mackley, David A Paul
OBJECTIVE: The aim of the study is to determine length of stay and length of treatment in infants with neonatal abstinence syndrome (NAS) in the neonatal intensive care unit (NICU) compared to those in the pediatric floor. METHODS: Retrospective cohort of infants ≥34 weeks gestation admitted with diagnosis of NAS at a single regional perinatal referral center from July 2014 to October 2015. A standardized NAS protocol for both the NICU and pediatric floor, which included guidelines for the initiation of oral morphine, escalation, and weaning, was followed...
September 24, 2018: Journal of Addiction Medicine
Hayley Friedman, Gregory Parkinson, Hocine Tighiouart, Catherine Parkinson, David Tybor, Norma Terrin, Barry Lester, Karen Harvey-Wilkes, Jonathan M Davis
OBJECTIVE: To compare length of hospital stay (LOS), LOS due to neonatal abstinence syndrome (NAS), and duration of pharmacologic treatment in community or academic settings. STUDY DESIGN: One hundred-two infants exposed to opioids in utero at two community hospitals were compared to 256 from eight academic centers. All infants were managed with non-pharmacologic care followed by similar pharmacologic treatment options. RESULTS: Two hundred-twelve infants received pharmacologic treatment for NAS...
September 20, 2018: Journal of Perinatology: Official Journal of the California Perinatal Association
Clea A McNeely, Sadie Hutson, Tara L Sturdivant, Jennifer M Jabson, Brittany S Isabell
CONTEXT: Law enforcement has been the primary strategy for addressing the opioid epidemic. As a result, the incarceration rate for women in county jails has increased more than 800% since 1980, and most women inmates struggle with substance use disorders. There is a large unmet need for contraception among women in county jails. PROGRAM: The East Region of the Tennessee Department of Health partnered with county correctional facilities to provide comprehensive family planning education and voluntary long-acting reversible contraception (LARC) to women in 15 jails...
September 18, 2018: Journal of Public Health Management and Practice: JPHMP
Jennifer L Syvertsen, Hannah Toneff, Danielle R Madden, John D Clapp
BACKGROUND: The opioid epidemic remains a serious issue in the United States and presents additional challenges for women of childbearing age. An increasingly common complication of opioid use is neonatal abstinence syndrome (NAS), or infant withdrawal from in utero exposure to opioids. PURPOSE: The objective of our qualitative study was to identify service needs and barriers to care in the NAS epidemic in Ohio, which has among the highest rates of opioid use and NAS in the nation...
September 18, 2018: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
Michelle J Wang, Spencer G Kuper, Brian Sims, Cayce S Paddock, John Dantzler, Suzanne Muir, Lorie M Harper
OBJECTIVE:  We sought to compare the efficacy and safety of detoxification from opioids compared with opioid replacement therapy (ORT) during pregnancy. STUDY DESIGN:  We searched PubMed, Embase, Cochrane Library, and from inception to June 2017 for English-language randomized-controlled trials or cohort studies that compared detoxification with ORT. We sought studies with outcomes data on maternal abstinence at the time of delivery, neonatal abstinence syndrome (NAS), stillbirth, and preterm birth (PTB)...
September 19, 2018: American Journal of Perinatology
Veeral N Tolia, Karna Murthy, Monica M Bennett, Rachel G Greenberg, Daniel K Benjamin, P Brian Smith, Reese H Clark
OBJECTIVE: To estimate the relationship of initial pharmacotherapy with methadone or morphine and length of stay (LOS) in infants with neonatal abstinence syndrome (NAS) admitted to the neonatal intensive care unit (NICU). STUDY DESIGN: From the Pediatrix Clinical Data Warehouse database, we identified all infants born at ≥36 weeks of gestation between 2011 and 2015 who were diagnosed with NAS (International Classification of Diseases, Ninth Revision code 779...
September 14, 2018: Journal of Pediatrics
Karen A McQueen
No abstract text is available yet for this article.
October 2018: Evidence-based Nursing
Mary-Margaret A Fill, Angela M Miller, Rachel H Wilkinson, Michael D Warren, John R Dunn, William Schaffner, Timothy F Jones
BACKGROUND: Neonatal abstinence syndrome (NAS) is a postnatal drug withdrawal syndrome that can occur after intrauterine opioid exposure. Adverse neurobehavioral outcomes have been documented in infants with NAS; however, educational outcomes have not been thoroughly examined. We analyzed Tennessee data to understand the need for special educational services among infants who are born with NAS. METHODS: By using Tennessee Medicaid and birth certificate data, infants who were born in Tennessee between 2008 and 2011 with a history of NAS were matched (1:3) to infants who were born during the same period without a history of NAS...
September 2018: Pediatrics
L Davidson, M Rawat, S Stojanovski, P Chandrasekharan
BACKGROUND: Mitragyna speciosa, also known as kratom, is obtained from the coffee plant family 'Rubiaceae.' Kratom is available in the form of capsules, whole, processed and powdered leaves and as liquids. Secondary to its 'natural herb' status and opioid effects, it is misconceived to be a safe alternative for the treatment of chronic pain. The use of kratom has increased by tenfold in the United States since 2010. METHODS AND RESULTS: We report a term neonate who was born to a chronic kratom user and required treatment with opiates for neonatal drug withdrawal...
August 22, 2018: Journal of Neonatal-perinatal Medicine
C S Crabtree, M Pakvasa, P G Radmacher, D H Adamkin
OBJECTIVE: The study objective was to explore the relationship between necrotizing enterocolitis (NEC) and packed red blood cell (pRBC) transfusion in very low birth weight (VLBW) neonates (<1500 g). STUDY DESIGN: A six-year retrospective chart review of VLBW infants with NEC (Bell's Stage > II) and a pRBC transfusion within 48 hours of diagnosis. Prenatal data, postnatal course, transfusion history, and NEC outcomes were reviewed. The transfusion associated necrotizing enterocolitis (TANEC) cases were matched with controls (1:2) who were transfused but did not develop NEC as to proximity of birth date, gestational age, and receipt of transfusion...
August 23, 2018: Journal of Neonatal-perinatal Medicine
C Nicholas Cuneo
No abstract text is available yet for this article.
August 21, 2018: JAMA: the Journal of the American Medical Association
Brad J Shapiro, Soraya Azari, Hendrée E Jones
No abstract text is available yet for this article.
August 21, 2018: JAMA: the Journal of the American Medical Association
Alicia Kowalchuk, Maria Mejia de Grubb, Roger Zoorob
No abstract text is available yet for this article.
August 21, 2018: JAMA: the Journal of the American Medical Association
Sarah E Wakeman, Davida M Schiff, Jessica Gray
No abstract text is available yet for this article.
August 21, 2018: JAMA: the Journal of the American Medical Association
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