How Long Do You Monitor Neonates for Neonatal Abstinence Syndrome (NAS)?

Discussion Neonatal abstinence syndrome (NAS) occurs in the first few days of life and is a complex withdrawal syndrome. The newborn is abruptly cut-off from their exposure to licit or illicit drugs that the mother is chronically consuming and which were being transmitted through the placenta to the fetus. “NAS is a highly variable and severe condition; it may be associated with central and autonomic nervous system dysfunction … and gastrointestinal disorders.” It can cause significant morbidity but is rarely fatal. Fetal exposure has been increasing in the United States. In 2011-12, almost 5.9% of pregnant women were identified as drug abusers with the highest proportion being in the adolescent age group (15-17 years, 18.3%). A variety of drugs can cause it including opioids, methamphetamines and psychotropic agents. Fetuses exposed to opioids can have prematurity, intrauterine growth restriction, low birth weight, congenital anomalies and NAS. Transplacental passage of opioids increases with increasing gestational age and can also pass into the breast milk. Maternal treatment for drug addition can include long-acting opioids and other medications such as methadone or buprenorphine. Neonates of mothers using buprenorphine usually have milder post-natal courses than those treated with methadone, which is thought to be due to combinations of environment, physiologic and genetic factors. NAS has variable onset, presentation and severity. Early onset (within 48...
Source: PediatricEducation.org - Category: Pediatrics Authors: Tags: Uncategorized Source Type: news