Neonatal Abstinence Syndrome and Preterm Infants: A Look at Current Practice.
Journal
Advances in neonatal care : official journal of the National Association of Neonatal Nurses
ISSN: 1536-0911
Titre abrégé: Adv Neonatal Care
Pays: United States
ID NLM: 101125644
Informations de publication
Date de publication:
01 04 2021
01 04 2021
Historique:
pubmed:
24
3
2021
medline:
26
11
2021
entrez:
23
3
2021
Statut:
ppublish
Résumé
Intrauterine 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. This study explored the current state of practice for preterm infants born at less than 34 weeks of gestational age exposed to intrauterine opioids. This 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. There 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. Great 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. Future research describing the NAS symptomatology of preterm infants born at less than 34 weeks of gestational age exposed to intrauterine opioids is warranted.
Sections du résumé
BACKGROUND/SIGNIFICANCE
Intrauterine 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.
PURPOSE
This study explored the current state of practice for preterm infants born at less than 34 weeks of gestational age exposed to intrauterine opioids.
METHODS
This 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.
RESULTS
There 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 PRACTICE
Great 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 RESEARCH
Future research describing the NAS symptomatology of preterm infants born at less than 34 weeks of gestational age exposed to intrauterine opioids is warranted.
Identifiants
pubmed: 33756498
doi: 10.1097/ANC.0000000000000858
pii: 00149525-202104000-00005
doi:
Substances chimiques
Morphine
76I7G6D29C
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
107-114Informations de copyright
Copyright © 2021 by the National Association of Neonatal Nurses.
Déclaration de conflit d'intérêts
The authors declare no conflicts of interest.
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