Abstract

A REVIEW OF LATEST BULLETIN ON NEONATAL ABSTINENCE SYNDROME

K. Harika, K. Deepthi, Venkata Rohit Kumar Chandolu*, J. N. Suresh Kumar

ABSTRACT

Neonatal abstinence syndrome was first described in the literature in 1970s by Loretta Finnegan. Although this syndrome has been recognised for more than 10 years there have been substantial changes in past 10 years. Neonatal abstinence syndrome (NAS) is a drug withdrawal syndrome experienced shortly after birth by infants who were exposed to opioids in utero. It can be severe and cause long hospital stays after birth and with symptoms up to 6 months after birth. It shows a group of similar behavioural and physiological signs and symptoms. Most common symptoms include hyper irritability, excessive crying, poor sleep, poor feeding, diarrhoea, hypertonia and tremors. Without proper treatment and care the infant born with Neonatal abstinence syndrome is at significant risk of neonatal morbidity and mortality. Depending upon by aetiology, type of drug, the severity of withdrawal and the age the neonate care maybe provided. Variability in assessment and treatment of Neonatal abstinence syndrome has been attributed to the lack of high quality evidence to guide management of exposed neonates. Different medications have been used to ameliorate symptoms of withdrawal, most commonly opioids. Morphine and methadone are currently the most commonly prescribed opioids to treated Neonatal abstinence syndrome. Buprenorphine is emerging treatment option with promising initial experience.

Keywords: Neonatal abstinence syndrome, infants, opioids, in utero, neonatal morbidity and mortality, assessment and treatment.