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Neonatal abstinence syndrome

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https://www.readbyqxmd.com/read/28093465/neonatal-abstinence-syndrome-and-high-school-performance
#1
Ju Lee Oei, Edward Melhuish, Hannah Uebel, Nadin Azzam, Courtney Breen, Lucinda Burns, Lisa Hilder, Barbara Bajuk, Mohamed E Abdel-Latif, Meredith Ward, John M Feller, Janet Falconer, Sara Clews, John Eastwood, Annie Li, Ian M Wright
BACKGROUND AND OBJECTIVES: Little is known of the long-term, including school, outcomes of children diagnosed with Neonatal abstinence syndrome (NAS) (International Statistical Classification of Disease and Related Problems [10th Edition], Australian Modification, P96.1). METHODS: Linked analysis of health and curriculum-based test data for all children born in the state of New South Wales (NSW), Australia, between 2000 and 2006. Children with NAS (n = 2234) were compared with a control group matched for gestation, socioeconomic status, and gender (n = 4330, control) and with other NSW children (n = 598 265, population) for results on the National Assessment Program: Literacy and Numeracy, in grades 3, 5, and 7...
January 16, 2017: Pediatrics
https://www.readbyqxmd.com/read/28086944/prenatal-treatment-for-opioid-dependency-observations-from-a-large-inner-city-clinic
#2
Kelley Saia, Sarah M Bagley, Elisha M Wachman, Payal P Patel, Marisa D Nadas, Susan B Brogly
BACKGROUND: The objective of this study was to review changes in the prevalence of opioid use disorder in pregnancy, and to describe the prenatal care and neonatal outcomes following the implementation of buprenorphine treatment at a large US obstetrical clinic during the on-going opioid epidemic. METHODS: We conducted a retrospective cohort study of 310 women (332 pregnancies) with opioid use disorders and their neonates delivered between June 2006 and December 2010 at an obstetrical clinic in the US...
January 13, 2017: Addiction Science & Clinical Practice
https://www.readbyqxmd.com/read/28079573/medically-assisted-withdrawal-detoxification-considering-the-mother-infant-dyad
#3
Hendrée E Jones, Mishka Terplan, Marjorie Meyer
Recommendations for opioid agonist pharmacotherapy and against medically assisted withdrawal were based upon early reports that associated withdrawal with maternal relapse and fetal demise. Data from recent case series have called these recommendations into question. Although these data do not support an association between medically assisted withdrawal and fetal demise, relapse remains a significant clinical concern with reported rates ranging from 17% to 96% (average 48%). Given the high loss to follow-up in these studies, the actual relapse rate is likely even greater...
January 11, 2017: Journal of Addiction Medicine
https://www.readbyqxmd.com/read/28078167/a-novel-strategy-for-attenuating-opioid-withdrawal-in-neonates
#4
Giovanni C Santoro, Samarth Shukla, Krishna Patel, Jakub Kaczmarzyk, Stergiani Agorastos, Sandra Scherrer, Yoon Young Choi, Christina Veith, Joseph Carrion, Rebecca Silverman, Danielle Mullin, Mohamed Ahmed, Wynne K Schiffer, Jonathan D Brodie, Stephen L Dewey
The rate of Neonatal Abstinence Syndrome (NAS) has drastically increased over the past decade. The average hospital expense per NAS patient has tripled, while the number of babies born to opioid-dependent mothers has increased to 5 in 1000 births. Current treatment options are limited to opioid replacement and tapering. Consequently, we examined the efficacy of prenatal, low-dose and short-term vigabatrin (γ-vinyl GABA, GVG) exposure for attenuating these symptoms as well as the metabolic changes observed in the brains of these animals upon reaching adolescence...
August 2016: Journal of Addiction Research & Therapy
https://www.readbyqxmd.com/read/28073819/the-opioid-epidemic-and-neonatal-abstinence-syndrome-in-the-usa-a-review-of-the-continuum-of-care
#5
Jason R Pryor, Faouzi I Maalouf, Elizabeth E Krans, Robert E Schumacher, William O Cooper, Stephen W Patrick
As the prescription opioid epidemic grew in the USA, its impact extended to pregnant women and their infants. This review summarises how increasing rates of neonatal abstinence syndrome resulted in a need to improve care to pregnant women and opioid-exposed infants. We discuss the variations in care delivery with particular emphasis on screening at-risk mothers, scoring systems for neonatal drug withdrawal, type and duration of pharmacotherapy, and discharge safety.
January 10, 2017: Archives of Disease in Childhood. Fetal and Neonatal Edition
https://www.readbyqxmd.com/read/28002715/neonatal-abstinence-syndrome
#6
REVIEW
Karen McQueen, Jodie Murphy-Oikonen
No abstract text is available yet for this article.
22, 2016: New England Journal of Medicine
https://www.readbyqxmd.com/read/28002062/nonopioid-management-of-neonatal-abstinence-syndrome
#7
Anne-Marie Boucher
BACKGROUND: Current standard therapy for moderate to severe neonatal abstinence syndrome (NAS) includes opioid administration and often results in separation of mother and infant. Impaired maternal-infant bonding and extended neonatal opiate exposure may be associated with adverse developmental outcomes. Increased use of nonopioid adjunctive NAS therapies may decrease postnatal opioid exposure and length of stay (LOS), thereby promoting positive developmental outcomes for NAS-affected infants...
December 20, 2016: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
https://www.readbyqxmd.com/read/27983768/association-of-maternal-and-infant-variants-in-pnoc-and-comt-genes-with-neonatal-abstinence-syndrome-severity
#8
Elisha M Wachman, Marie J Hayes, Richard Sherva, Mark S Brown, Hira Shrestha, Beth A Logan, Nicole A Heller, David A Nielsen, Lindsay A Farrer
BACKGROUND AND OBJECTIVES: There is significant variability in severity of neonatal abstinence syndrome (NAS) due to in utero opioid exposure. Our previous study identified single nucleotide polymorphisms (SNPs) in the prepronociceptin (PNOC) and catechol-O-methyltransferase (COMT) genes that were associated with differences in NAS outcomes. This study looks at the same SNPs in PNOC and COMT in an independent cohort in an attempt to replicate previous findings. METHODS: For the replication cohort, full-term opioid-exposed newborns and their mothers (n = 113 pairs) were studied...
January 2017: American Journal on Addictions
https://www.readbyqxmd.com/read/27974484/buprenorphine-norbuprenorphine-r-methadone-and-s-methadone-upregulate-bcrp-abcg2-expression-by-activating-aryl-hydrocarbon-receptor-in-human-placental-trophoblasts
#9
Naveen K Neradugomma, Michael Z Liao, Qingcheng Mao
Opioid dependence during pregnancy is a rising concern. Maintaining addicted pregnant women on long-acting opioid receptor agonist is the most common strategy to manage pregnancy drug abuse. Methadone (MET) and Buprenorphine (BUP) are widely prescribed for opiate-maintenance therapy. Norbuprenorphine (NBUP) is the primary active metabolite of BUP. These medications can cross the placenta to the fetus, leading to postpartum neonatal abstinence syndrome. Despite their use during pregnancy, little is known about the cellular changes brought about by these drugs in the placenta...
December 14, 2016: Molecular Pharmacology
https://www.readbyqxmd.com/read/27942711/rural-and-urban-differences-in-neonatal-abstinence-syndrome-and-maternal-opioid-use-2004-to-2013
#10
Nicole L G Villapiano, Tyler N A Winkelman, Katy B Kozhimannil, Matthew M Davis, Stephen W Patrick
No abstract text is available yet for this article.
December 12, 2016: JAMA Pediatrics
https://www.readbyqxmd.com/read/27926654/neonatal-abstinence-syndrome-and-ethical-approaches-to-the-identification-of-pregnant-women-who-use-drugs
#11
Mishka Terplan, Howard Minkoff
The United States is experiencing an epidemic of opioid use, addiction, and neonatal abstinence syndrome. Consequentially, a great deal of public, and public health, attention has turned toward the timely recognition of pregnant women who use drugs. We explore the clinical efficacy and ethical acceptability of different methods of identification-contrasting drug testing (using biologic samples such as urine) with screening (using an instrument or questionnaire) under both universal and selective approaches within the current legal and social landscape, which is fraught with potential adverse consequences for both the woman and her child...
January 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27907936/early-treatment-for-neonatal-abstinence-syndrome-a-palliative-approach
#12
Jennifer Hudson, Rachel Mayo, Lori Dickes, Liwei Chen, Windsor Westbrook Sherrill, Julie Summey, Bradley Dalton, Kindal Dankovich
Objective To describe medical, safety, and health care utilization outcomes associated with an early treatment model for neonatal opioid withdrawal. Study Design This is a retrospective review of 117 opioid-exposed infants born in a large regional hospital and treated in the level I nursery with methadone initiated within 48 hours of birth. Results For this cohort, mean length of stay was 8.3 days. Hospital safety events were infrequent; there were no medication errors or deaths. Within 30 days of discharge, 14% of infants visited the emergency department; 7% were readmitted...
December 1, 2016: American Journal of Perinatology
https://www.readbyqxmd.com/read/27889436/wide-variation-found-in-care-of-opioid-exposed-newborns
#13
Debra L Bogen, Bonny L Whalen, Laura R Kair, Mark Vining, Beth A King
OBJECTIVE: Standardized practices for the management of neonatal abstinence syndrome (NAS) are associated with shorter lengths of stay, but optimal protocols are not established. We sought to identify practice variations for newborns with in utero chronic opioid exposure among hospitals in the Better Outcomes Through Research for Newborns (BORN) network. METHODS: Nursery site leaders completed a survey about hospitals' policies and practices regarding care for infants with chronic opioid exposure (≥3 weeks)...
November 23, 2016: Academic Pediatrics
https://www.readbyqxmd.com/read/27886650/the-relationship-between-gestational-age-and-the-severity-of-neonatal-abstinence-syndrome
#14
Kelly S Gibson, Ms Sydney Stark, Deepak Kumar, Jennifer L Bailit
BACKGROUND AND AIMS: The relationship between gestational age at delivery and the severity of neonatal abstinence syndrome (NAS) is poorly understood. Our objective was to compare the length of pharmacotherapy and hospital stay among opioid exposed infants born during the late preterm, early term, full term, and late term periods. DESIGN: Retrospective cohort study of infants affected by NAS SETTING: MetroHealth Medical Center in Cleveland, Ohio, USA: an urban tertiary care hospital serving as the referral center for opioid dependency in pregnancy with a level III neonatal intensive care unit PARTICIPANTS: All deliveries complicated by maternal opioid exposure from January 2000 to October 2014; 403 were eligible to be included (n = 102 Late Preterm, 34-36weeks (LP), n = 158 Early Term, 37-38weeks (ET), n = 122 Full Term, 39-40weeks (FT), n = 21 Late Term, ≥41 weeks (LT))...
November 25, 2016: Addiction
https://www.readbyqxmd.com/read/27876117/neonatal-abstinence-syndrome-and-the-gastrointestinal-tract
#15
Denise Maguire, Maureen Gröer
Development of a healthy gut microbiome is essential in newborns to establish immunity and protection from pathogens. Recent studies suggest that infants who develop dysbiosis may be at risk for lifelong adverse health consequences. Exposure to opioid drugs during pregnancy is a factor of potential importance for microbiome health that has not yet been investigated. Since these infants are born after an entire gestation exposed to mu opioid receptor agonists and have severe gastrointestinal and neurological symptoms, we hypothesize that these infants are at risk for dysbiosis...
December 2016: Medical Hypotheses
https://www.readbyqxmd.com/read/27821184/a-core-outcome-set-for-neonatal-abstinence-syndrome-study-protocol-for-a-systematic-review-parent-interviews-and-a-delphi-survey
#16
Lauren E Kelly, Lauren M Jansson, Wendy Moulsdale, Jodi Pereira, Sarah Simpson, Astrid Guttman, Karel Allegaert, Lisa Askie, Henry Roukema, Thierry Lacaze, Jonathan M Davis, Loretta Finnegan, Paula Williamson, Martin Offringa
BACKGROUND: The prevalence of neonatal abstinence syndrome (NAS) is increasing globally resulting in an increased incidence of adverse neonatal outcomes and health system costs. Evidence regarding the effectiveness of NAS prevention and management strategies is very weak and further research initiatives are critically needed to support meta-analysis and clinical practice guidelines. In NAS research, the choice of outcomes and the use of valid, responsive and feasible measurement instruments are crucial...
November 8, 2016: Trials
https://www.readbyqxmd.com/read/27799240/observational-study-of-the-safety-of-buprenorphine-naloxone-in-pregnancy-in-a-rural-and-remote-population
#17
Naana Afua Jumah, Craig Edwards, Jazmyn Balfour-Boehm, Kassandra Loewen, Joseph Dooley, Lianne Gerber Finn, Len Kelly
OBJECTIVES: To describe the effect of in utero exposure to the buprenorphine+naloxone combination product in a rural and remote population. SETTING: A district hospital that services rural and remote, fly-in communities in Northwestern Ontario, Canada. PARTICIPANTS: A retrospective cohort study was conducted of 855 mother infant dyads between 1 July 2013 and 30 June 2015. Cases included all women who had exposure to buprenorphine+naloxone during pregnancy (n=62)...
October 31, 2016: BMJ Open
https://www.readbyqxmd.com/read/27729254/opioid-dependence-and-pregnancy-minimizing-stress-on-the-fetal-brain
#18
REVIEW
John J McCarthy, Martin H Leamon, Loretta P Finnegan, Catherine Fassbender
Increase in the number of opioid-dependent pregnant women delivering babies at risk for neonatal abstinence syndrome prompted a US Government Accountability Office report documenting deficits in research and provider knowledge about care of the maternal/fetal unit and the neonate. There are 3 general sources of dependence: untreated opioid use disorder, pain management, and medication-assisted treatment with methadone or buprenorphine. A survey of methadone patients' experiences when telling a physician of their pregnancy and opioid dependence demonstrated physician confusion about proper care, frequent negative interactions with the mother, and failures to provide appropriate referral...
October 8, 2016: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27723910/neonatal-abstinence-syndrome-twelve-years-of-experience-at-a-regional-referral-center
#19
S Mücke, M Nagel, J P Siedentopf, C Bührer, D Hüseman
Background: Infants exposed to opiates antenatally display withdrawal symptoms after birth referred to as neonatal abstinence syndrome (NAS). Patients: A total of 366 newborns (166 females, 10 twins) from 361 mothers were diagnosed with NAS from 2000 to 2011 at a single large metropolitan referral center. Methods: Retrospective chart review of all newborn infants exposed to opiates in utero. Results: 20% were premature (gestational age<37 weeks), 32% were small-for-gestational-age (<10(th) percentile)...
October 10, 2016: Klinische Pädiatrie
https://www.readbyqxmd.com/read/27695339/a-comparison-of-morphine-delivery-in-neonatal-opioid-withdrawal
#20
Brian Chisamore, Safaa Labana, Sandra Blitz, Alice Ordean
Current estimates of the prevalence of opioid withdrawal in newborns from the 2012 Better Outcomes Registry and Network Ontario reveal that more than 4 births per 1000 display recognizable symptoms of neonatal abstinence syndrome (NAS). With a growing consensus surrounding aspects of newborn opioid withdrawal care, clinicians might agree that all infants exposed to maternal opioids require supportive observation and care to ensure appropriate adaptation and growth in the newborn period and, likewise, that there exists a smaller percentage of newborns who require additional pharmacotherapy...
2016: Substance Abuse: Research and Treatment
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