Opioid induced neonatal abstinence syndrome

Daniella Meytin1

1Lithuanian University of Health Sciences, Academy of Medicine, Faculty of Medicine

Abstract

A newborn born to a mother who used opioids during pregnancy is at risk for neonatal withdrawal syndrome (NAS). The clinical signs of NAS are different in each case, their abundance and severity depend on the duration of maternal addiction, amount of drug used and type of it, maternal factors (nutrition, stress, metabolism), genetic factors, neonatal factors (gestational age, metabolism, infections), and placental metabolism. Signs of NAS include dysfunction of the autonomic nervous, central nervous, and gastrointestinal systems. Typical symptoms include high-pitched crying, irritability, increased wakefulness, difficulty eating, digestive problems, and an inability to gain weight. NAS is diagnosed based on mother’s history of drug use, positive results of tests for drugs in biological fluids, and clinical signs of NAS.

Aim: to determine the etiology, epidemiology, symptomatic, diagnostics, and treatment of opioid induced neonatal abstinence syndrome.

Methods: a systematic review of the literature was performed using the PubMed medical database. Selected articles examining the etiology, symptomatic, epidemiology, diagnosis, and treatment of opioid induced neonatal abstinence syndrome. English word combinations were used for search: neonatal opioid withdrawal syndrome, opioids, neonatal abstinence syndrome, neonatal withdrawal syndrome, in utero exposure to opioids.

Conclusions. A newborn born to a mother who used opioids during pregnancy is at risk for neonatal withdrawal syndrome (NAS). The clinical signs of NAS are different in each case, but include dysfunction of the autonomic nervous system, CNS, and gastrointestinal system. Typical symptoms include high-pitched crying, irritability, increased wakefulness, difficulty eating, digestive problems, and an inability to gain weight. NAS is diagnosed based on mother’s history of drug use, positive results of tests for drugs in biological fluids, and clinical signs of NAS. It should be borne in mind that test results may be false negative.

Keywords: neonatal opioid withdrawal syndrome, neonatal abstinence syndrome, neonatal withdrawal syndrome, NAS, opioids.