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Neonatal abstinence syndrome

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https://www.readbyqxmd.com/read/28941590/method-performance-and-clinical-workflow-outcomes-associated-with-meconium-and-umbilical-cord-toxicology-testing
#1
Ruth M Labardee, Jaime R Swartzwelder, Karen E Gebhardt, Justine A Pardi, Anna C Dawsey, R Brent Dixon, Steven W Cotten
OBJECTIVE: Neonatal abstinence syndrome (NAS) is a rising concern with unknown long-term effects. It is apparent that higher cost of care, impact on the community and reduced quality of life are associated with similar etiologies (e.g., fetal alcohol syndrome). Detection of drug exposure in utero allows for earlier intervention to potentially reduce undesired outcomes. Umbilical cord tissue (UCT) has been documented as a readily accessible specimen for detection of drug exposure and has emerged as an alternative specimen to meconium...
September 20, 2017: Clinical Biochemistry
https://www.readbyqxmd.com/read/28917206/maternal-and-infant-outcomes-following-third-trimester-exposure-to-marijuana-in-opioid-dependent-pregnant-women-maintained-on-buprenorphine
#2
Alane B O'Connor, Brandon K Kelly, Liam M O'Brien
BACKGROUND: To determine whether maternal and infant outcomes are associated with exposure to marijuana during the third trimester in a population of opioid dependent pregnant women maintained on buprenorphine. METHODS: This retrospective cohort study of 191 maternal-infant dyads exposed to buprenorphine during pregnancy examines a variety of variables including gestational age, birthweight, method of delivery, Apgar scores at one and five minutes, duration of infant hospital stay, peak neonatal abstinence syndrome (NAS) score, duration of NAS and incidence of pharmacologic treatment of NAS in infants exposed to marijuana during the third trimester as compared to infants not exposed to marijuana during the third trimester...
September 7, 2017: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/28891099/opioid-and-benzodiazepine-weaning-in-pediatric-patients-review-of-current-literature
#3
Norman E Fenn, Kimberly S Plake
Pediatric opioid and benzodiazepine withdrawal are avoidable complications of pain and sedation management that is well described in the literature. To prevent withdrawal from occurring, practitioners regularly employ a steady decrease of pain and sedation medications, also known as a weaning or tapering schedule. The weaning schedule is highly variable based on clinician preference and is usually dependent on the clinician. The purpose of this review is to evaluate the current literature on the process of opioid and benzodiazepine weaning in pediatric patients and to assess the various standardized protocols used to decrease withdrawal occurrences...
September 11, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28879171/the-genomics-of-neonatal-abstinence-syndrome
#4
REVIEW
F Sessions Cole, Daniel J Wegner, Jonathan M Davis
Significant variability has been observed in the development and severity of neonatal abstinence syndrome (NAS) among neonates exposed to prenatal opioids. Since maternal opioid dose does not appear to correlate directly with neonatal outcome, maternal, placental, and fetal genomic variants may play important roles in NAS. Previous studies in small cohorts have demonstrated associations of variants in maternal and infant genes that encode the μ-opioid receptor (OPRM1), catechol-O-methyltransferase (COMT), and prepronociceptin (PNOC) with a shorter length of hospital stay and less need for treatment in neonates exposed to opioids in utero...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28877016/buprenorphine-for-the-neonatal-abstinence-syndrome
#5
LETTER
Walter K Kraft, Susan C Adeniyi-Jones, Michelle E Ehrlich
New England Journal of Medicine, Volume 377, Issue 10, Page 996-998, September 2017.
September 7, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28877015/buprenorphine-for-the-neonatal-abstinence-syndrome
#6
LETTER
Stephen Christiansen
No abstract text is available yet for this article.
September 7, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28869859/maternal-buprenorphine-treatment-and-infant-outcome
#7
Lauren M Jansson, Martha L Velez, Krystle McConnell, Nancy Spencer, Michelle Tuten, Hendree Jones, Rebeca Rios, Van L King, Neeraj Gandotra, Lorraine Millio, Janet A DiPietro
BACKGROUND AND OBJECTIVES: Maternal buprenorphine maintenance predisposes the infant to exhibit neonatal abstinence syndrome (NAS), but there is insufficient published information regarding the nature of NAS and factors that contribute to its severity in buprenorphine-exposed infants. METHODS: The present study evaluated forty-one infants of buprenorphine-maintained women in comprehensive substance use disorder treatment who participated in an open-label study examining the effects of maternal buprenorphine maintenance on infant outcomes...
August 31, 2017: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/28829626/transitioning-from-methadone-to-buprenorphine-maintenance-in-management-of-opioid-use-disorder-during-pregnancy
#8
Shakevia Johnson, Peter R Martin
BACKGROUND: Opioid use disorder during pregnancy is a growing health concern. Methadone maintenance is the treatment of choice but emerging data indicate buprenorphine is a viable alternative. Due to costs and limited accessibility of methadone, pregnant women may require transition from methadone to buprenorphine for maintenance treatment. OBJECTIVES: To assess safety and effectiveness of transitioning from methadone to buprenorphine when necessary during pregnancy...
August 22, 2017: American Journal of Drug and Alcohol Abuse
https://www.readbyqxmd.com/read/28814260/neonatal-abstinence-syndrome-management-a-review-of-recent-evidence
#9
Matthew Grossman, Carl Seashore, Alison Volpe Holmes
BACKGROUND: The evaluation and management of infants with neonatal abstinence syndrome (NAS), the constellation of opioid withdrawal specific to newborns, has received renewed attention over the past decade during a new epidemic of opioid use, misuse, abuse, and dependence. Infants with NAS often endure long and costly hospital stays. OBJECTIVE: We aim to review recent literature on the management and outcomes of infants with, and at risk for, opioid withdrawal...
August 16, 2017: Reviews on Recent Clinical Trials
https://www.readbyqxmd.com/read/28804749/morphine-versus-methadone-treatment-for-neonatal-withdrawal-and-impact-on-early-infant-development
#10
Sharon Burke, Anna Malia Beckwith
Objective. Compare developmental outcomes in infants treated with morphine versus methadone. Method. Retrospective chart review of newborns identified through use of ICD-9 code for neonatal abstinence syndrome (NAS). Thirty-six infants were evaluated-17 treated with methadone and 19 treated with morphine. Assessment was completed following treatment using the Bayley Scales of Infant and Toddler Development-Third Edition (Bayley-III). Scores in Cognitive, Language, and Motor domains were compared. Results. Comparison of scores between morphine- and methadone-treated groups revealed differences in mean Cognitive Composite (91...
2017: Global Pediatric Health
https://www.readbyqxmd.com/read/28754255/tailoring-a-nicu-based-tobacco-treatment-program-for-mothers-who-are-dependent-on-opioids
#11
Amanda Fallin-Bennett, Kristin Ashford
OBJECTIVE: To collect formative information to design a tailored tobacco treatment intervention for women with newborns treated or evaluated for neonatal abstinence syndrome and to explore current tobacco use behaviors and facilitators and barriers to smoking cessation. DESIGN: Qualitative descriptive study. SETTING: An academic medical center in the southern United States. PARTICIPANTS: Mothers of newborns who were treated or evaluated for neonatal abstinence syndrome at birth within the preceding 3 months...
July 26, 2017: Journal of Obstetric, Gynecologic, and Neonatal Nursing: JOGNN
https://www.readbyqxmd.com/read/28742676/committee-opinion-no-711-opioid-use-and-opioid-use-disorder-in-pregnancy
#12
(no author information available yet)
Opioid use in pregnancy has escalated dramatically in recent years, paralleling the epidemic observed in the general population. To combat the opioid epidemic, all health care providers need to take an active role. Pregnancy provides an important opportunity to identify and treat women with substance use disorders. Substance use disorders affect women across all racial and ethnic groups and all socioeconomic groups, and affect women in rural, urban, and suburban populations. Therefore, it is essential that screening be universal...
August 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28742670/committee-opinion-no-711-summary-opioid-use-and-opioid-use-disorder-in-pregnancy
#13
(no author information available yet)
Opioid use in pregnancy has escalated dramatically in recent years, paralleling the epidemic observed in the general population. To combat the opioid epidemic, all health care providers need to take an active role. Pregnancy provides an important opportunity to identify and treat women with substance use disorders. Substance use disorders affect women across all racial and ethnic groups and all socioeconomic groups, and affect women in rural, urban, and suburban populations. Therefore, it is essential that screening be universal...
August 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28726245/opioid-use-and-abuse-and-neonatal-abstinence-syndrome
#14
EDITORIAL
C Lindsay DeVane
No abstract text is available yet for this article.
July 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28715290/trainees-knowledge-attitudes-and-practices-towards-caring-for-the-substance-exposed-mother-infant-dyad
#15
Davida M Schiff, Barry Zuckerman, Elisha M Wachman, Megan Bair-Merritt
BACKGROUND: As rates of substance use disorder during pregnancy rise, pediatric trainees are increasingly caring for infants with neonatal abstinence syndrome (NAS). This study evaluated the knowledge, attitudes, and practices of trainees caring for substance-exposed newborns and their families, comparing differences by level and type of training, and personal experience with addiction or trauma. METHODS: A cross-sectional survey of medical students and pediatric, medicine/pediatric, and family medicine residents in 2015-2106...
July 17, 2017: Substance Abuse
https://www.readbyqxmd.com/read/28685864/rural-and-appalachian-disparities-in-neonatal-abstinence-syndrome-incidence-and-access-to-opioid-abuse-treatment
#16
Joshua D Brown, Amie J Goodin, Jeffery C Talbert
OBJECTIVE: Incidence of neonatal abstinence syndrome (NAS) is increasing due to the rise in opioid use. Rural states like Kentucky have been disproportionally impacted by opioid abuse, and this study determines NAS burden nationally and in Kentucky while quantifying differences in access to care between Appalachian and non-Appalachian counties. METHODS: NAS rates were calculated using National (2013) and Kentucky (2008-2014) National Inpatient Sample discharge data...
July 7, 2017: Journal of Rural Health
https://www.readbyqxmd.com/read/28682319/neonatal-abstinence-syndrome-and-early-childhood-morbidity-and-mortality-in-washington-state-a-retrospective-cohort-study
#17
C E Witt, K E Rudd, P Bhatraju, F P Rivara, S E Hawes, N S Weiss
OBJECTIVE: The objective of the study was to evaluate the association between neonatal abstinence syndrome (NAS) and long-term childhood morbidity and infant mortality. STUDY DESIGN: We conducted a cohort study of infants born in Washington State during 1990 to 2008 who were diagnosed with NAS (n=1900) or were unexposed (n=12,283, frequency matched by birth year). 5-year hospital readmissions and infant mortality were ascertained. RESULTS: Children with history of NAS had increased risk of readmission during the first 5 years of life relative to unexposed children; this remained statistically significant after adjustment for maternal age, maternal education, gestational age and intrapartum smoking status (readmission rates: NAS=21...
July 6, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28682317/a-management-strategy-that-reduces-nicu-admissions-and-decreases-charges-from-the-front-line-of-the-neonatal-abstinence-syndrome-epidemic
#18
S Loudin, J Werthammer, L Prunty, S Murray, J I Shapiro, T H Davies
OBJECTIVE: The purpose of this study was to test a specialized needs-based management model for a high volume of babies born with neonatal abstinence syndrome (NAS) while controlling costs and reducing neonatal intensive care unit (NICU) bed usage. STUDY DESIGN: Data were analyzed from inborn neonates >35 weeks' gestational age with the diagnosis of NAS (ICD9-CM 779.5), requiring pharmacologic treatment and discharged from 2010 through 2015. Significance was determined using Kruskal-Wallis and Mann-Whitney as well as χ(2) for trend...
July 6, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28655728/opioid-use-during-pregnancy-a-population-based-cohort-study
#19
Jamie Falk, Matthew Dahl, Colette B Raymond, Dan Chateau, Alan Katz, Christine Leong, Shawn Bugden
BACKGROUND: Opioid use has increased dramatically in North America. The safety of opioids in pregnancy is uncertain, but they are associated with several fetal abnormalities and contribute to rising rates of neonatal abstinence syndrome. We examined opioid use before and during pregnancy in a complete population-based cohort. METHODS: We examined opioid use in a cohort of all pregnant women in Manitoba, Canada, from 2001 to 2013. Opioid use was defined by prescriptions for opioids, converted to oral morphine equivalents (MEQ), during the 3 months before pregnancy and for each trimester...
June 26, 2017: CMAJ Open
https://www.readbyqxmd.com/read/28655009/neonatal-abstinence-syndrome-better-treated-with-buprenorphine
#20
Anita Slomski
No abstract text is available yet for this article.
June 27, 2017: JAMA: the Journal of the American Medical Association
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