• Adv Neonatal Care · Apr 2021

    Neonatal Abstinence Syndrome and Preterm Infants: A Look at Current Practice.

    • Debra Armbruster, Caitlyn Schwirian, Ashley Mosier, Wai-Yin Mandy Tam, and Pavel Prusakov.
    • Departments of Neonatology (Dr Armbruster and Ms Mosier) and Pharmacy (Drs Schwirian, Tam, and Prusakov), Nationwide Children's Hospital, Columbus, Ohio.
    • Adv Neonatal Care. 2021 Apr 1; 21 (2): 107-114.

    Background/SignificanceIntrauterine opioid drug exposure is associated with an increased risk of preterm birth. Preterm infants may not exhibit the same withdrawal symptoms as term infants diagnosed with neonatal abstinence syndrome (NAS). There are no current standards for how to screen, assess, or treat NAS in preterm infants.PurposeThis study explored the current state of practice for preterm infants born at less than 34 weeks of gestational age exposed to intrauterine opioids.MethodsThis was a descriptive cross-sectional study of NAS practice in preterm infants born at less than 34 weeks of gestational age in neonatal intensive care units (NICUs) in the United States and Canada. The study was conducted May through September 2018. All respondents cared for preterm infants born at less than 34 weeks of gestational age exposed to intrauterine drugs.ResultsThere were 70 respondents representing 67 hospitals in the United States and 1 in Canada. Level III NICUs represented 69% of respondents. Ninety-three percent reported neonatal triggers for further evaluation. Review of maternal history and maternal urine testing was the most consistent practice across NICUs. A modified Finnegan scoring tool was used for both preterm and term infants. Morphine was reported as the most common first-line drug used for treatment.Implications For PracticeGreat variability in NAS practice for preterm infants born at less than 34 weeks of gestational age across the multiple NICUs supports the need for a validated preterm infant assessment tool and development of appropriate treatment strategies.Implications For ResearchFuture research describing the NAS symptomatology of preterm infants born at less than 34 weeks of gestational age exposed to intrauterine opioids is warranted.Copyright © 2021 by the National Association of Neonatal Nurses.

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