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Neonatal Abstinence Syndrome

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Developmental and behavioral outcomes of children with neonatal abstinence syndrome.

Raye-Ann deRegnier,

J. Pediatr. (The Journal of pediatrics)
[2020, 219:1-3]

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Testing Unconventional Matrices to Monitor for Prenatal Exposure to Heroin, Cocaine, Amphetamines, Synthetic Cathinones, and Synthetic Opioids.

Jeremy Carlier, Nunzia La Maida, Annagiulia Di Trana, Marilyn A Huestis, Simona Pichini, Francesco P Busardò,

BACKGROUND:The prevalence of drug use during pregnancy continues to increase despite the associated serious adverse obstetrical outcomes, including increased risk of miscarriage, fetal growth restriction, brain development impairment, neonatal abstinence syndrome, preterm delivery, and stillbirths. Monitoring drug use during pregnancy is crucial to limit prenatal exposure and provide suitable obstetrical ... Read more >>

Ther Drug Monit (Therapeutic drug monitoring)
[2020, 42(2):205-221]

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Implementing a Learning Collaborative Framework for States Working to Improve Outcomes for Vulnerable Populations: The Opioid Use Disorder, Maternal Outcomes, and Neonatal Abstinence Syndrome Initiative Learning Community.

Charlan D Kroelinger, Donna Addison, Mirelys Rodriguez, Marion E Rice, Meghan T Frey, Hadley R Hickner, Mary Kate Weber, Trish Mueller, Alisa Velonis, Keriann Uesugi, Lisa Romero, Sanaa Akbarali, Natalie Foster, Jean Y Ko, Ellen Pliska, Christine Mackie, Shanna Cox, S Nicole Fehrenbach, Wanda D Barfield,

The opioid crisis has impacted vulnerable populations, specifically pregnant and postpartum women, and infants prenatally exposed to substances, including infants with Neonatal Abstinence Syndrome. Lack of access to clinical and social services; potential stigma or discrimination; and lack of resources for provision of services, including screening and treatment, have impacted ... Read more >>

J Womens Health (Larchmt) (Journal of women's health (2002))
[2020, :]

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Monitoring Prenatal Exposure to Buprenorphine and Methadone.

Annagiulia Di Trana, Nunzia La Maida, Roberta Tittarelli, Marilyn A Huestis, Simona Pichini, Francesco P Busardò, Jeremy Carlier,

PURPOSE:Buprenorphine and methadone are international gold standards for managing opioid use disorders. Although they are efficacious in treating opioid dependence, buprenorphine and methadone present risks, especially during pregnancy, causing neonatal abstinence syndrome and adverse obstetrical outcomes. Buprenorphine and methadone are also abused during pregnancy, and identifying their use is important ... Read more >>

Ther Drug Monit (Therapeutic drug monitoring)
[2020, 42(2):181-193]

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Emerging therapies for the treatment of neonatal abstinence syndrome.

Lexus M Frazier, Lauren E Bobby, Kristen M Gawronski,

Objective: To examine the evidence for emerging treatment options, buprenorphine or clonidine, as monotherapy for the treatment of neonatal abstinence syndrome (NAS) against standards of care, morphine or methadone.Data sources: A PubMed literature search from 1946 to 2019 was performed using the terms NAS, neonatal withdrawal, buprenorphine and NAS, clonidine ... Read more >>

J. Matern. Fetal. Neonatal. Med. (The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians)
[2020, :1-9]

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Outcome reporting in neonates experiencing withdrawal following opioid exposure in pregnancy: a systematic review.

Flora Shan, Sonya MacVicar, Karel Allegaert, Martin Offringa, Lauren M Jansson, Sarah Simpson, Wendy Moulsdale, Lauren E Kelly,

BACKGROUND:Neonatal withdrawal secondary to in utero opioid exposure is a growing global concern stressing the psychosocial well-being of affected families and scarce hospital resources. In the ongoing search for the most effective treatment, randomized controlled trials are indispensable. Consistent outcome selection and measurement across randomized controlled trials enables synthesis of ... Read more >>

Trials (Trials)
[2020, 21(1):262]

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One-Year Postpartum Mental Health Outcomes of Mothers of Infants with Neonatal Abstinence Syndrome.

Tammy E Corr, Eric W Schaefer, Christopher S Hollenbeak, Douglas L Leslie,

INTRODUCTION:Women with substance use disorders have high incidences of psychiatric and mood disorders, which may affect their ability to cope with an infant with neonatal abstinence syndrome (NAS), particularly one with a protracted NICU course, exacerbating symptoms of mental health disorders. We examined the incidence of mental health diagnoses in ... Read more >>

Matern Child Health J (Maternal and child health journal)
[2020, 24(3):283-290]

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On "'Choose Physical Therapy' for Neonatal Abstinence Syndrome: Clinical Management for Infants Affected by the Opioid Crisis." McCarty DB, Peat JR, O'Donnell S, Graham E, Malcolm, WF. Phys Ther. 2019; 99;771-785.

Priti Kharel, Joshua Robert Zadro, Stephanie Mathieson, Christopher Maher,

Phys Ther (Physical therapy)
[2020, :]

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Evaluating the effect of hospital setting on outcomes for neonatal abstinence syndrome.

Matthew R Grossman, Adam K Berkwitt, Rachel R Osborn, Brett V Citarella, Daniela Hochreiter, Matthew J Bizzarro,

OBJECTIVES:This study aims to evaluate the impact of hospital setting on outcomes for infants with neonatal abstinence syndrome. STUDY DESIGN:We conducted a retrospective study in two hospitals and three different hospital units. The inpatient group (n = 60) was managed on general inpatient floors, the NICU group (n = 50) was managed primarily in ... Read more >>

J Perinatol (Journal of perinatology : official journal of the California Perinatal Association)
[2020, :]

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Development of an abbreviated symptom score for the neonatal abstinence syndrome.

I Chervoneva, S C Adeniyi-Jones, F Blanco, W K Kraft,

OBJECTIVE:We sought a shortened MOTHER neonatal abstinence syndrome (NAS) and Finnegan score that would retain comparable performance characteristics of the full instrument. STUDY DESIGN:Retrospective cohort. RESULTS:In total, 124,170 MOTHER NAS scores between August 2007 and May 2016 from 775 infants (≥36 weeks) were examined. Classification and regression tree model identified ... Read more >>

J Perinatol (Journal of perinatology : official journal of the California Perinatal Association)
[2020, :]

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High Prevalence of Buprenorphine in Prenatal Drug Screens in an Appalachian City.

Charlotte Alexander, Kevin Breuel, Martin Olsen,

OBJECTIVES:To define the magnitude of buprenorphine presence in the urine drug screens of pregnant women and to assess the presence of illicit buprenorphine use versus the presence of prescribed buprenorphine use. METHODS:Initial prenatal drug screen results for all pregnant patients in our practice for a 1-year period were analyzed and ... Read more >>

South. Med. J. (Southern medical journal)
[2020, 113(3):111-115]

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Stereoselective Analysis of Methadone and EDDP in Laboring Women and Neonates in Plasma and Dried Blood Spots and Association with Neonatal Abstinence Syndrome.

Ingrid F Metzger, Anna E Thomas, Cindy A Evrard, David R Jones, Andrea R Masters, David M Haas, Laura S Haneline, Sara K Quinney,

OBJECTIVE: This pilot study evaluated the relationship between maternal and neonatal R- and S-methadone and R- and S-2-ethylidene-1,5-dimethyl-3,3-diphenylpyrrolidine (EDDP) exposure and the severity of neonatal abstinence syndrome (NAS). The use of dried blood spots (DBS) as an alternative for plasma in assessing methadone and EDDP was also assessed. STUDY DESIGN: Women receiving ... Read more >>

Am J Perinatol (American journal of perinatology)
[2020, :]

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Inclusion of Positive Self-reporting by Mothers of Substance Exposed Neonates Increases the Predictability of NAS Severity Over Toxicology Alone.

Danielle Roth, Sean Loudin, Lacey Andrews, Joseph Evans, Todd H Davies,

OBJECTIVES:The rise in opioid use among pregnant women has resulted in an increase in the incidence of neonatal abstinence syndrome (NAS). Despite the focus on opioid use, prenatal polysubstance exposure is often associated with NAS diagnosis and severity. Drug toxicology screens such as urine drug screens and umbilical cord toxicology ... Read more >>

Matern Child Health J (Maternal and child health journal)
[2020, 24(3):340-350]

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The Parental Experience of Newborns With Neonatal Abstinence Syndrome Across Inpatient Care Settings: A Qualitative Study.

Amy Buczkowski, Olivia Avidan, David Cox, Alexa Craig,

OBJECTIVES:Understanding the experience of parents with newborns hospitalized with neonatal abstinence syndrome (NAS) across all inpatient settings is important in optimizing their involvement as part of the care team. A descriptive qualitative study design was utilized to understand the parental experience and identify barriers to parent involvement in care of ... Read more >>

J Addict Med (Journal of addiction medicine)
[2020, :]

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Intrauterine Substance Exposure and the Risk for Subsequent Physical Abuse Hospitalizations.

Henry T Puls, James D Anderst, Karen Farst, Matthew Hall,

OBJECTIVES:To describe the relative risk for a physical abuse hospitalization among substance exposed infants (SEI) with and without neonatal abstinence syndrome (NAS). METHODS:We created a nationally representative U.S. birth cohort using the 2013 and 2014 Nationwide Readmissions Databases. International Classification of Diseases, Ninth Revision, Clinical Modification codes were used to ... Read more >>

Acad Pediatr (Academic pediatrics)
[2020, :]

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Neonatal intensive care unit admissions before and after the adoption of the baby friendly hospital initiative.

Eliza C Fradkin, Margaret A Lafferty, Jay S Greenspan, Zubair H Aghai,

Background: The Baby Friendly Hospital initiative (BFHI) is a global initiative of the World Health Organization developed in 1991 to promote and support successful breastfeeding. It has led to increased rates of exclusive breastfeeding. Exclusive breastfeeding may increase risk for hypoglycemia, hyperbilirubinemia, and dehydration requiring higher level of neonatal care.Objective: ... Read more >>

J. Matern. Fetal. Neonatal. Med. (The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians)
[2020, :1-6]

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Hospital Care of Opioid-Exposed Newborns: Clinical and Psychosocial Challenges.

Neera K Goyal, Jennifer McAllister,

In the past two decades, the incidence of neonatal abstinence syndrome (NAS) has risen fivefold, mirroring the rise of opioid use disorder (OUD) among pregnant women. The resulting increases in length of stay and neonatal intensive care utilization are associated with higher hospital costs, particularly among Medicaid-financed deliveries. Pregnant women ... Read more >>

J Hosp Med (Journal of hospital medicine)
[2020, 15(2):e1-e6]

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Neurodevelopmental Outcomes of Neonates Randomized to Morphine or Methadone for Treatment of Neonatal Abstinence Syndrome.

Adam J Czynski, Jonathan M Davis, Lynne M Dansereau, Barbara Engelhardt, Peter Marro, Debra L Bogen, Mark L Hudak, Jeffrey Shenberger, Elisha M Wachman, Erica L Oliveira, Barry M Lester,

OBJECTIVE:To evaluate the effects of pharmacologic treatment of neonatal abstinence syndrome on neurodevelopmental outcome from a randomized, controlled trial. STUDY DESIGN:Eight sites enrolled 116 full-term newborn infants with neonatal abstinence syndrome born to mothers maintained on methadone or buprenorphine into a randomized trial of morphine vs methadone. Ninety-nine infants (85%) ... Read more >>

J. Pediatr. (The Journal of pediatrics)
[2020, 219:146-151.e1]

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Neonatal Abstinence Syndrome: Leveraging Health Information Technology to Develop a Data-Driven National Policy Approach.

Shahla M Jilani, Brett P Giroir,

Public Health Rep (Public health reports (Washington, D.C. : 1974))
[2020, 135(2):173-176]

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Enduring consequences of perinatal fentanyl exposure in mice.

Jason B Alipio, Adam T Brockett, Megan E Fox, Stephen S Tennyson, Coreylyn A deBettencourt, Dina El-Metwally, Nikolas A Francis, Patrick O Kanold, Mary Kay Lobo, Matthew R Roesch, Asaf Keller,

Opioid use by pregnant women is an understudied consequence associated with the opioid epidemic, resulting in a rise in the incidence of neonatal opioid withdrawal syndrome (NOWS) and lifelong neurobehavioral deficits that result from perinatal opioid exposure. There are few preclinical models that accurately recapitulate human perinatal drug exposure and ... Read more >>

Addict Biol (Addiction biology)
[2020, :e12895]

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An Update on the Burden of Neonatal Abstinence Syndrome in the United States.

Kamleshun Ramphul, Stephanie Gonzalez Mejias, Jyotsnav Joynauth,

OBJECTIVES:To provide an estimate on the most recent burden of neonatal abstinence syndrome (NAS) in the United States. METHODS:The 2016 Kids' Inpatient Database, provided by the Healthcare Cost and Utilization Project and Agency for Healthcare Research and Quality and its partners, was used to identify patients with NAS in the ... Read more >>

Hosp Pediatr (Hospital pediatrics)
[2020, 10(2):181-184]

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Screening for Opioid and Stimulant Exposure in utero via Targeted and Untargeted Metabolomics Analysis of Umbilical Cords.

Srivalli Swathi Mamillapalli, Annalisa Smith-Joyner, Lauren Forbes, Kadesha McIntyre, Samantha Poppenfuse, Blake Rushing, Cody Strom, Allison Danell, Linda May, Devon Kuehn, Kimberly Kew, Srikanth Ravisankar,

BACKGROUND:Neonatal abstinence syndrome (NAS) is an array of signs and symptoms experienced by a newborn due to abrupt discontinuation of intrauterine exposure to certain drugs, primarily opioids. In the United States, the incidence of NAS has tripled over the last decade. Current standard of care for drug testing includes the ... Read more >>

Ther Drug Monit (Therapeutic drug monitoring)
[2020, :]

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The Effects of Neonatal Abstinence Syndrome on Language Delay from Birth to 10 Years.

Jennifer Shearer Miller, Joel G Anderson, Paul Campbell Erwin, Sharon K Davis, Lisa C Lindley,

PURPOSE:To examine the longitudinal effects of a history of neonatal abstinence syndrome (NAS) on language development over the first 10 years of life. DESIGN AND METHODS:This study used a retrospective, longitudinal design. The data were analyzed using generalized linear mixed models (GLMM) to examine the effects of NAS on language delay ... Read more >>

J Pediatr Nurs (Journal of pediatric nursing)
[2020, 51:67-74]

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2019 Update on Pediatric Medical Overuse: A Systematic Review.

Nathan M Money, Alan R Schroeder, Ricardo A Quinonez, Timmy Ho, Jennifer R Marin, Daniel J Morgan, Sanket S Dhruva, Eric R Coon,

Importance:Medical overuse is common in pediatrics and may lead to unnecessary care, resource use, and patient harm. Timely scrutiny of established and emerging practices can identify areas of overuse and empower clinicians to reconsider the balance of harms and benefits of the medical care that they provide. A literature review ... Read more >>

JAMA Pediatr (JAMA pediatrics)
[2020, :]

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Torticollis in infants with neonatal abstinence syndrome.

Craig V Towers, Amber Knapper, Mark Gaylord, Tara Burnette, Ryan Neal, Mark Hennessy,

OBJECTIVE:To report the incidence of torticollis diagnosed in infants treated for neonatal abstinence syndrome (NAS) and compare neonates with and without torticollis. STUDY DESIGN:This prospective cohort study reports on infants examined at 1-4 months of age. Numerous obstetrical/newborn factors and other drugs used during gestation were compared. RESULTS:Of 501 neonates ... Read more >>

J Perinatol (Journal of perinatology : official journal of the California Perinatal Association)
[2020, :]

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