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Neonatal abstinance

Craig V Towers, Branson W Hyatt, Kevin C Visconti, Lindsey Chernicky, Katie Chattin, Kimberly B Fortner
OBJECTIVES: To compare head circumference (HC) in neonates treated for neonatal abstinence syndrome (NAS) with control neonates without antenatal opioid exposure. METHODS: Our prospective cohort study ran from April 1, 2014, through December 31, 2016. Newborns treated for NAS delivered from well-dated pregnancies ≥34 weeks' gestation were compared with newborns who were nonopioid exposed and matched for race, parity, mode of delivery, and gestational age. All mothers underwent serial antenatal urine drug testing...
December 10, 2018: Pediatrics
Faouzi I Maalouf, William O Cooper, Shannon M Stratton, Judith A Dudley, Jean Ko, Anamika Banerji, Stephen W Patrick
OBJECTIVES: Neonatal abstinence syndrome (NAS) is a postnatal withdrawal syndrome experienced by some infants with opioid exposure. Hospital administrative data are commonly used for research and surveillance but have not been validated for NAS. Our objectives for this study were to validate the diagnostic codes for NAS and to develop an algorithm to optimize identification. METHODS: Tennessee Medicaid claims from 2009 to 2011 (primary sample) and 2016 (secondary sample; post- International Classification of Diseases, 10th Revision, Clinical Modification [ ICD-10-CM ]) were obtained...
December 4, 2018: Pediatrics
Catherine Butcher, Leesa Prunty, Omar Attarabeen, Charles C K Babcock, Isha Patel
No abstract text is available yet for this article.
October 2018: Journal of Addictions Nursing
Mara G Coyle, Susan B Brogly, Mahmoud S Ahmed, Stephen W Patrick, Hendrée E Jones
Neonatal abstinence syndrome refers to the signs and symptoms attributed to the cessation of prenatal exposure (via placental transfer) to various substances. This Primer focuses on neonatal abstinence syndrome caused by opioid use during pregnancy - neonatal opioid withdrawal syndrome (NOWS). As the global prevalence of opioid use has alarmingly increased, so has the incidence of NOWS. NOWS can manifest with varying severity or not at all, for unknown reasons, but is likely to be associated with multiple factors, both maternal (for example, smoking and additional substance exposures) and neonatal (gestational age, sex and genetics)...
November 22, 2018: Nature Reviews. Disease Primers
(no author information available yet)
No abstract text is available yet for this article.
November 22, 2018: Nature Reviews. Disease Primers
Paul Thiessen
No abstract text is available yet for this article.
September 2018: Paediatrics & Child Health
Laura J Sherman, Mir M Ali, Ryan Mutter, Justine Larson
No abstract text is available yet for this article.
November 20, 2018: Psychiatric Services: a Journal of the American Psychiatric Association
Nancy J MacMullen, Linda F Samson
There is an uncontrollable epidemic of drug abuse, with the misuse of opioids the most alarming. Along with the increase in opioid abuse, there exists a concomitant upsurge in the number of neonates experiencing neonatal abstinence syndrome (NAS) due to the effects of the mother's withdrawal from the drug. Neonates experiencing NAS exhibit various nervous system, gastrointestinal, and respiratory untoward symptoms. Diagnosis is determined by taking an accurate maternal history and assessment of clinical signs and symptoms...
December 2018: Critical Care Nursing Clinics of North America
Emma M Nellhaus, Sara Murray, Zachary Hansen, Sean Loudin, Todd H Davies
Neonatal abstinence syndrome (NAS) is a withdrawal syndrome observed in neonates exposed to drugs in utero, typically opioids, which is associated with symptoms affecting the central and autonomic nervous systems and the gastrointestinal system. West Virginia, particularly the southeastern region of the state, has remarkably higher rates of NAS than similar communities. Our facility is increasingly faced with complex cases of NAS caused by in utero exposure to multiple substances. We present a case report of a neonate born to a 25-year-old mother enrolled in a medication-assisted treatment program for substance use disorder who was noncompliant in prenatal care, using multiple substances throughout the pregnancy, including gabapentin and fentanyl...
November 8, 2018: Journal of Pediatric Health Care
Whitney B Eldridge, Cherie Foster, Lance Wyble
Neonatal abstinence syndrome (NAS) is increasing in incidence and most commonly associated with maternal opioid use during pregnancy. Nonopioid alternatives to treat opioid dependence are highly sought after in the country's current opioid epidemic. Whether Kratom, a legal, widely available herbal supplement, should be classified as an opioid is contentious. Although the US Food and Drug Administration has recently addressed this controversy, Kratom continues to be marketed as a nonopioid remedy for opioid withdrawal...
November 7, 2018: Pediatrics
Danwei Wu, Camille Carre
Neonatal abstinence syndrome (NAS) is a neurologic condition resulting from prenatal exposure to opioids. The sudden cessation of opioids in neonates can lead to withdrawal symptoms affecting the neurologic, respiratory, and gastrointestinal systems. Rising opioid use in the United States has led to an increased incidence of infants born with NAS. Despite the growing incidence of NAS, there is a lack of standardized guidelines for intervention and management. Recent studies suggest that non-pharmacological methods should be used as first-line interventions for the reduction of NAS symptoms...
July 28, 2018: Curēus
Tammy E Corr, Eric W Schaefer, Ian M Paul
BACKGROUND: Infants with neonatal abstinence syndrome (NAS) initially experience neurologic excitability, poor feeding, and/or hyperphagia in the setting of increased metabolic demand. Because the longitudinal effects of these early symptoms and behaviors on weight trends are unknown, we sought to contrast weight gain patterns through age 1 year for infants diagnosed with NAS with matched controls. METHODS: Retrospective cohort of 70 singletons with a gestational age of ≥37 weeks and an ICD-9 or ICD-10 diagnosis of NAS made ≤7 days after birth with institutional follow-up matched to patients without NAS...
November 5, 2018: BMC Pediatrics
Katy B Kozhimannil, Tongtan Chantarat, Alexandra M Ecklund, Carrie Henning-Smith, Cresta Jones
PURPOSE: Opioid use disorder (OUD) during pregnancy is associated with poor maternal and infant outcomes, including neonatal abstinence syndrome (NAS), and both maternal OUD and NAS are increasing disproportionately among rural residents. This study describes the trajectory and characteristics associated with diagnosis of maternal OUD or NAS among rural residents who gave birth at different types of hospitals based on rural/urban location and teaching status. METHODS: Hospital discharge data from the all-payer National Inpatient Sample were used to describe maternal OUD and infant NAS among rural residents from 2007-2014...
October 29, 2018: Journal of Rural Health
Mirjam Pocivalnik, Manfred Danda, Berndt Urlesberger, Wolfgang Raith
Background : Selective serotonin reuptake inhibitors are a very common choice of antidepressive drug-therapy during pregnancy. In up to 30% of cases, they have been found to cause neonatal abstinence syndrome in newborn infants. Although often both time-limiting and self-limiting, severe symptoms of neonatal abstinence syndrome (NAS) can occur. Methods/Results: We report a term male infant suffering from a severe brief resolved unexplained event caused by his mother's sertraline intake during pregnancy. Conclusions : Newborn infants exposed to selective serotonine reuptake inhibitors (SSRIs) during pregnancy should be evaluated very carefully concerning NAS and monitored for NAS symptoms for a minimum of 72⁻96 h, or until symptoms have fully recovered using standardized protocols...
October 22, 2018: Medicines (Basel, Switzerland)
Zoe F Cairncross, Jeremy Herring, Trevor van Ingen, Brendan T Smith, Pamela Leece, Brian Schwartz, Karin Hohenadel
BACKGROUND: Negative health outcomes associated with the use of both prescribed and nonprescribed opioids are increasingly prevalent. We examined long-term trends in opioid-related harms in Ontario across a set of 6 indicators and the relation between harms and neighbourhood income in 2016. METHODS: We examined rates of neonatal abstinence syndrome, opioid poisoning (fatal and nonfatal) and nonpoisoning opioid-related events from 2003 to 2016 in Ontario using population-based health administrative databases...
October 2018: CMAJ Open
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 and 2015...
October 1, 2018: Addiction
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