Neonatal Abstinence Syndrome: Update on Diagnostic and Therapeutic Strategies

Pharmacotherapy

Volumn 37, Issue 7, 2017, Pages 814-823

  Raffaeli, Genny ^a   Cavallaro, Giacomo ^a   Allegaert, Karel ^b   Wildschut, Enno Diederik ^c   Fumagalli, Monica ^a   Agosti, Massimo ^d   Tibboel, Dick ^c   Mosca, Fabio ^a  

^a UNIVERSITY OF MILAN   (Italy)

^b UNIVERSITY OF LEUVEN   (Belgium)

^c SOPHIA CHILDREN S HOSPITAL   (Netherlands)

^d Ospedale F del Ponte   (Italy)

Author keywords

benzodiazepine; methadone; morphine; neonatal abstinence syndrome; opioid; pregnancy drug abuse

Indexed keywords

BUPRENORPHINE; CLONIDINE; MORPHINE; PHENOBARBITAL; ANTIDEPRESSANT AGENT; METHADONE; NARCOTIC ANALGESIC AGENT;

BREAST FEEDING; CLINICAL OUTCOME; FINNEGAN SCORING SYSTEM; FOLLOW UP; HUMAN; LIPSITZ NEONATAL WITHDRAWAL SCALE; MENTAL DISEASE ASSESSMENT; MULTICENTER STUDY (TOPIC); NEONATAL ABSTINENCE SYNDROME; PHASE 1 CLINICAL TRIAL (TOPIC); RANDOMIZED CONTROLLED TRIAL (TOPIC); RATING SCALE; REVIEW; RIVERS TOOL; SCORING SYSTEM; TREATMENT OUTCOME; CHEMICALLY INDUCED; FEMALE; MENTAL DISEASE; NEWBORN; OPIATE SUBSTITUTION TREATMENT; PREGNANCY; UTILIZATION;

ANALGESICS, OPIOID; ANTIDEPRESSIVE AGENTS; BUPRENORPHINE; FEMALE; HUMANS; INFANT, NEWBORN; METHADONE; NEONATAL ABSTINENCE SYNDROME; NEURODEVELOPMENTAL DISORDERS; OPIATE SUBSTITUTION TREATMENT; PREGNANCY;

EID: 85021804628     PISSN: 02770008     EISSN: 18759114     Source Type: Journal    
DOI: 10.1002/phar.1954     Document Type: Review

References (64)

1. Finnegan L, Connaughton J Jr, Kron R, Emich J. Neonatal abstinence syndrome: assessment and management. Addict Dis 1974;1–2:141–58.
2. Doberczak TM, Kandal SR, Wilets I. Neonatal opiate abstinence syndrome in term and preterm infants. J Pediatr 1991;6:933–7.
3. Rivers R. Neonatal opiate withdrawal. Arch Dis Child 1986;12:1236–9.
4. Bada HS, Das A, Bauer CR, et al. Low birth weight and preterm births: etiologic fraction attributable to prenatal drug exposure. J Perinatol 2005;10:631–7.
5. Tolia VN, Patrick SW, Bennett MM, et al. Increasing incidence of the neonatal abstinence syndrome in US neonatal ICUs. N Engl J Med 2015;22:2118–26.
6. Abuse Mental Health Services Administration. Results from the 2012 national survey on drug use and health: summary of national findings. NSDUH Series No. H-46, HHS Publication No. (SMA) 13–4795, 2013. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2014.
7. SAMHSA Center for Behavioral Health Statistics and Quality. National survey on drug use and health, 2008–2011. Available from http://archive.samhsa.gov/data/NSDUH/2011SummNatFindDetTables/NSDUH-DetTabsPDFWHTML2011/2k11DetailedTabs/Web/HTML/NSDUH-DetTabsSect6peTabs55to107-2011.htm - Tab 6.72A. 2012. Accessed June 22, 2017.
8. Patrick SW, Schumacher RE, Benneyworth BD, Krans EE, McAllister JM, Davis MM. Neonatal abstinence syndrome and associated health care expenditures: United States, 2000–2009. JAMA 2012;18:1934–40.
9. U.S. Congress S.799 – Protecting our Infants Act of 2015. Available from https://www.congress.gov/bill/114th-congress/senate-bill/799. Accessed May 17, 2016. 2015.
10. Patrick SW, Dudley J, Martin PR, et al. Prescription opioid epidemic and infant outcomes. Pediatrics 2015;5:842–50.
11. Warren MD, Miller AM, Traylor J, Bauer A, Patrick SW. Implementation of a statewide surveillance system for neonatal abstinence syndrome—Tennessee, 2013. MMWR Morb Mortal Wkly Rep 2015;5:125–8.
12. Turner SD, Gomes T, Camacho X, et al. Neonatal opioid withdrawal and antenatal opioid prescribing. CMAJ Open 2015;1:E55.
13. Davies H, Gilbert R, Johnson K, et al. Neonatal drug withdrawal syndrome: cross-country comparison using hospital administrative data in England, the USA, Western Australia and Ontario, Canada. Arch Dis Child Fetal Neonatal Ed 2016;101:F26–30.
14. Kocherlakota P. Neonatal abstinence syndrome. Pediatrics 2014;2:e547–61.
15. Patrick S, Davis M, Lehmann CU, Cooper W. Increasing incidence and geographic distribution of neonatal abstinence syndrome: United States 2009 to 2012. J Perinatol 2015;8:650–5.
16. Unger A, Jagsch R, Jones H, et al. Randomized controlled trials in pregnancy: scientific and ethical aspects. Exposure to different opioid medications during pregnancy in an intra-individual comparison. Addiction 2011;7:1355–62.
17. Hudak ML, Tan RC, Frattarelli DA, et al. Neonatal drug withdrawal. Pediatrics 2012;2:e540–60.
18. Lewis T, Dinh J, Leeder J. Genetic determinants of fetal opiate exposure and risk of neonatal abstinence syndrome: knowledge deficits and prospects for future research. Clin Pharmacol Ther 2015;3:309–20.
19. Hall ES, Wexelblatt SL, Crowley M, et al. Implementation of a neonatal abstinence syndrome weaning protocol: a multicenter cohort study. Pediatrics 2015;4:e803–10.
20. Ogunyemi D, Hernandez-Loera G. The impact of antenatal cocaine use on maternal characteristics and neonatal outcomes. J Matern Fetal Neonatal Med 2004;4:253–9.
21. Campolongo P, Trezza V, Palmery M, Trabace L, Cuomo V. Developmental exposure to cannabinoids causes subtle and enduring neurofunctional alterations. Int Rev Neurobiol 2009;117–33.
22. Scott-Goodwin A, Puerto M, Moreno I. Toxic effects of prenatal exposure to alcohol, tobacco and other drugs. Reprod Toxicol 2016;120–30.
23. Kearns GL, Abdel-Rahman SM, Alander SW, Blowey DL, Leeder JS, Kauffman RE. Developmental pharmacology—drug disposition, action, and therapy in infants and children. N Engl J Med 2003;12:1157–67.
24. Szeto HH. Kinetics of drug transfer to the fetus. Clin Obstet Gynecol 1993;2:246–54.
25. Akil H, Watson SJ, Young E, Lewis ME, Khachaturian H, Walker JM. Endogenous opioids: biology and function. Annu Rev Neurosci 1984;1:223–55.
26. Nanovskaya TN, Nekhayeva IA, Hankins GD, Ahmed MS. Transfer of methadone across the dually perfused preterm human placental lobule. Am J Obstet Gynecol 2008;1:126e1-26. e4.
27. Stein C. Opioid receptors. Annu Rev Med 2016;433–51.
28. Barr GA, McPhie-Lalmansingh A, Perez J, Riley M. Changing mechanisms of opiate tolerance and withdrawal during early development: animal models of the human experience. ILAR J 2011;3:329–41.
29. Convertino I, Sansone AC, Marino A, et al. Neonatal adaptation issues after maternal exposure to prescription drugs: withdrawal syndromes and residual pharmacological effects. Drug Saf 2016;10:903–24.
30. Wachman EM, Hayes MJ, Brown MS, et al. Association of OPRM1 and COMT single-nucleotide polymorphisms with hospital length of stay and treatment of neonatal abstinence syndrome. JAMA 2013;17:1821–7.
31. Wachman EM, Hayes MJ, Lester BM, et al. Epigenetic variation in the mu-opioid receptor gene in infants with neonatal abstinence syndrome. J Pediatr 2014;3:472–8.
32. Salisbury AL, Ponder KL, Padbury JF, Lester BM. Fetal effects of psychoactive drugs. Clin Perinatol 2009;3:595–619.
33. Anand KJ, Willson DF, Berger J, et al. Tolerance and withdrawal from prolonged opioid use in critically ill children. Pediatrics 2010;5:e1208–25.
34. Herzlinger RA, Kandall SR, Vaughan HG. Neonatal seizures associated with narcotic withdrawal. J Pediatr 1977;4:638–41.
35. Jones HE, Kaltenbach K, Heil SH, et al. Neonatal abstinence syndrome after methadone or buprenorphine exposure. N Engl J Med 2010;24:2320–31.
36. Lipsitz PJ. A proposed narcotic withdrawal score for use with newborn infants a pragmatic evaluation of its efficacy. Clin Pediatr 1975;6:592–4.
37. Allocco E, Melker M, Rojas-Miguez F, Bradley C, Hahn KA, Wachman EM. Comparison of neonatal abstinence syndrome manifestations in preterm versus term opioid-exposed infants. Adv Neonatal Care 2016;5:329–36.
38. Lozano J, García-Algar O, Vall O, de la Torre R, Scaravelli G, Pichini S. Biological matrices for the evaluation of in utero exposure to drugs of abuse. Ther Drug Monit 2007;6:711–34.
39. Concheiro M, González-Colmenero E, Lendoiro E, et al. Alternative matrices for cocaine, heroin, and methadone in utero drug exposure detection. Ther Drug Monit 2013;4:502–9.
40. Cotten SW. Drug testing in the neonate. Clin Lab Med 2012;3:449–66.
41. McMillin GA, Wood KE, Strathmann FG, Krasowski MD. Patterns of drugs and drug metabolites observed in meconium: what do they mean? Ther Drug Monitor 2015;5:568–80.
42. Patrick SW, Schumacher RE, Horbar JD, et al. Improving care for neonatal abstinence syndrome. Pediatrics 2016;137:e20153835.
43. Wiles JR, Isemann B, Ward LP, Vinks AA, Akinbi H. Current management of neonatal abstinence syndrome secondary to intrauterine opioid exposure. J Pediatr 2014;3:440–6.
44. Rossen L, Hutchinson D, Wilson J, et al. Predictors of postnatal mother-infant bonding: the role of antenatal bonding, maternal substance use and mental health. Arch Womens Ment Health 2016;1–14.
45. Abdel-Latif ME, Pinner J, Clews S, Cooke F, Lui K, Oei J. Effects of breast milk on the severity and outcome of neonatal abstinence syndrome among infants of drug-dependent mothers. Pediatrics 2006;6:e1163–9.
46. Reece-Stremtan S, Marinelli KA. ABM clinical protocol# 21: guidelines for breastfeeding and substance use or substance use disorder, revised 2015. Breastfeed Med 2015;3:135–41.
47. McQueen K, Murphy-Oikonen J. Neonatal abstinence syndrome. N Engl J Med 2016;25:2468–79.
48. Napolitano A, Theophilopoulos D, Seng SK, Calhoun DA. Pharmacologic management of neonatal abstinence syndrome in a community hospital. Clin Obstet Gynecol 2013;1:193–201.
49. Patrick S, Kaplan H, Passarella M, Davis M, Lorch S. Variation in treatment of neonatal abstinence syndrome in US Children's Hospitals, 2004–2011. J Perinatol 2014;11:867–72.
50. Osborn DA, Jeffery HE, Cole MJ. Sedatives for opiate withdrawal in newborn infants. Cochrane Database Syst Rev 2010.
51. Osborn DA, Jeffery HE, Cole MJ. Opiate treatment for opiate withdrawal in newborn infants. Cochrane Database Syst Rev 2010.
52. Kraft WK, Dysart K, Greenspan JS, Gibson E, Kaltenbach K, Ehrlich ME. Revised dose schema of sublingual buprenorphine in the treatment of the neonatal opioid abstinence syndrome. Addiction 2011;3:574–80.
53. Ohio Children's Hospitals Neonatal Research Consortium. Enternal morphine or methadone protocol for neonatal abstinence syndrome (NAS) from maternal exposure. Available from https://opqc.net/sites/bmidrupalpopqc.chmcres.cchmc.org/files/NAS/Ohio%20Childrens%20NAS%20Treatment%20Protocol%200822%20 2013%20%20FINALrev2.pdf. Accessed August 22, 2013.
54. Kraft WK, Stover MW, Davis JM. Neonatal abstinence syndrome: pharmacologic strategies for the mother and infant. Semin Perinatol 2016;3:203–12.
55. Wiles JR, Isemann B, Mizuno T, et al. Pharmacokinetics of oral methadone in the treatment of neonatal abstinence syndrome: a pilot study. J Pediatr 2015;6(1214–20):e3.
56. Ng CM, Dombrowsky E, Lin H, et al. Population pharmacokinetic model of sublingual buprenorphine in neonatal abstinence syndrome. Pharmacotherapy 2015;7:670–80.
57. Streetz VN, Gildon BL, Thompson DF. Role of clonidine in neonatal abstinence syndrome a systematic review. Ann Pharmacother 2016;4:301–10.
58. Bouwmeester NJ, Anderson BJ, Tibboel D, Holford NH. Developmental pharmacokinetics of morphine and its metabolites in neonates, infants and young children. Br J Anaesth 2004;2:208–17.
59. Davis J, Lester B. Improving outcomes in neonatal abstinence syndrome. ClinicalTrialsgov. Bethesda, MD: National Library of Medicine. Available from https://clinicaltrialsgov/show/NCT 01958476 NLM Identifier: NCT 01958476. Accessed January 31, 2017.
60. Kraft WK. A randomized, active-control, double-blind, double-dummy clinical trial comparing sublingual buprenorphine and morphine solution for the treatment of neonatal opioid abstinence syndrome. ClinicalTrialsgov. Bethesda, MD: National Library of Medicine. Available from https://clinicaltrialsgov/show/NCT01452789 NLM Identifier: NCT 01452789. Accessed January 31, 2017.
61. Smirk CL, Bowman E, Doyle LW, Kamlin O. Home-based detoxification for neonatal abstinence syndrome reduces length of hospital admission without prolonging treatment. Acta Paediatr 2014;6:601–4.
62. Sirnes E, Oltedal L, Bartsch H, Eide GE, Elgen IB, Aukland SM. Brain morphology in school-aged children with prenatal opioid exposure: a structural MRI study. Early Hum Develop 2017;106-107:33–9.
63. Walhovd KB, Bjørnebekk A, Haabrekke K, et al. Child neuroanatomical, neurocognitive, and visual acuity outcomes with maternal opioid and polysubstance detoxification. Pediatr Neurol 2015;3(326–32):e3.
64. Kelly LE, Jansson LM, Moulsdale W, et al. A core outcome set for neonatal abstinence syndrome: study protocol for a systematic review, parent interviews and a Delphi survey. Trials 2016;17:536.