Impact of Neonatal Abstinence on Newborns

Background: Neonatal abstinence syndrome (NAS) is a multisystemic disorder resulting from the sudden discontinuation of fetal exposure to drugs for whom the mother has developed addiction.

Objective: Evaluate the prevalence of NAS and the impact and morbidity on children.

Methods: Retrospective review of newborn (NB) diagnosed with NAS from 2006-2019. The sample was divided in two groups – A: NB from opioid addicted mothers, B: NB from mothers on psychiatric drugs. Statistical analysis was performed using SPSS (a<0.05).

Results: 49 infants, 44 on group A and 5 on B. NAS prevalence rate was 1.6‰ ( 3.5 cases/year). 18.4% pregnancies had no medical vigilance. Methadone was the most frequent drug (65.3%) with 61.4% having multiple consumptions. 55.1% of mothers had HCV infection, 70.5% were in a detox program (DP). In group A, 22.7% NB were underweight, 13.6% premature. 14 of all NB had congenital malformations. The average hospital stay was 21.64 days. Finnegan score (FS) was lower in preterm, with statistically significant difference (p=0.029). A moderate linear correlation was obtained between maximum FS and hospital stay (r=0.539). 27 NB underwent therapy, 66.7% with chlorpromazine. 17 NB were discharged to childcare centers (52.9% of mothers were in a DP), 8 were adopted. All were referred to a neonatology appointment and median follow-up time was 16M (0-76M). Among patients still being followed up, the most frequent diagnosis was hyperactivity disorder and attention deficit. Some of these patients have concomitant cognitive impairment.

Conclusion: Hospital stay was prolonged, probably due to the inherent social situation. According to what is described in literature, FS was lower in preterm. We cannot yet establish a clear relationship between prenatal exposure to drugs and developmental disorders, but we have found a high percentage of behavioral disorders in these children and, therefore, monitoring is essential.