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Prematurity reduces the severity and need for treatment of neonatal abstinence syndrome
Author(s) -
Ruwanpathirana Radhika,
AbdelLatif Mohamed E.,
Burns Lucy,
Chen Julia,
Craig Fiona,
Lui Kei,
Oei Ju Lee
Publication year - 2015
Publication title -
acta paediatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/apa.12910
Subject(s) - medicine , interquartile range , gestation , methadone , gestational age , pediatrics , abstinence , pregnancy , anesthesia , psychiatry , genetics , biology
Aim This study determined the influence of prematurity on the manifestation and treatment of neonatal abstinence syndrome ( NAS ). Methods This was a medical record review of Australian infants exposed to opiates in 2004 and 2007. Finnegan scores were obtained for 215 of 361 (59%) preterm infants under 37‐week gestation and 694 of 1178 (59%) term infants. Results The mean and standard deviation ( SD ) gestational ages were 34 (3) and 38 (3) weeks for preterm and term infants, respectively. Maternal daily methadone doses were similar for the preterm and term infants with a mean ( SD ) of 79 mg (39) versus 72 mg (38) (p = 0.06). Maximum Finnegan scores were significantly lower in preterm infants (10 versus 11, p = 0.01), scores were positively correlated with gestation and fewer preterm infants were medicated for NAS (40% versus 48% p = 0.05). Maximum median daily and interquartile range morphine doses were lower for preterm than term infants (0.5 mg/kg/day (0.3–0.6) versus 0.5 mg/kg/day (0.4–0.7), p = 0.02). Conclusion Preterm infants were just as likely to be monitored for withdrawal as term infants, but their Finnegan scores were lower and fewer preterm infants were treated for NAS . Whether this indicates decreased NAS severity or physiological immaturity is uncertain. Other means of evaluating NAS in preterm infants are warranted, especially long‐term outcomes.