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How long should infants at risk of drug withdrawal be monitored after birth?
Author(s) -
Smirk Cameron L,
Bowman Ellen,
Doyle Lex W,
Kamlin Camille Omar Farouk
Publication year - 2014
Publication title -
journal of paediatrics and child health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.631
H-Index - 76
eISSN - 1440-1754
pISSN - 1034-4810
DOI - 10.1111/jpc.12513
Subject(s) - medicine , pediatrics , pregnancy , gestation , retrospective cohort study , opiate , abstinence , drug withdrawal , drug , psychiatry , surgery , genetics , receptor , biology
Aim Neonatal abstinence syndrome ( NAS ) is an increasingly common disorder diagnosed in infants exposed to various drugs, causing immense financial and social burden. Recommendations from various bodies are for babies to be monitored for 4 to 7 days following birth so that prompt treatment can commence should symptoms develop. We aimed to determine the best post‐natal observation period in babies at risk of NAS . Methods A retrospective review was undertaken of infants ≥35 weeks' gestation who received treatment for NAS in the period 2001–2010. During this time, the standard post‐natal observation period was a minimum of 7 days. Data including drug exposure, day of admission and day of treatment were collected. Results Two hundred and ten babies were included. Drug exposure was predominantly to opiates (99%); however, most infants (58%) were exposed to additional substances (benzodiazepines, cannabis or amphetamines). Ninety‐five per cent of infants were admitted by day 5 of life. Of the babies treated by day 7, 98.5% had been admitted to the nursery by day 5. Infants with polydrug exposure were admitted significantly earlier; however, time to treatment was not significantly different to those exposed to opiate replacement therapy alone. Conclusions In our hospital, babies treated for NAS often required admission before day 5. This has implications for hospital resource allocation, suggesting that routine post‐natal observation for NAS could be shortened to 5 days. Further research is needed to help identify neonates who require more careful post‐natal observation.