Document Detail


Predicting treatment for neonatal abstinence syndrome in infants born to women maintained on opioid agonist medication.
MedLine Citation:
PMID:  23106926     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIM: To identify factors that predict the expression of neonatal abstinence syndrome (NAS) in infants exposed to methadone or buprenorphine in utero.
DESIGN AND SETTING: Multi-site randomized clinical trial in which infants were observed for a minimum of 10 days following birth, and assessed for NAS symptoms by trained raters.
PARTICIPANTS: A total of 131 infants born to opioid dependent mothers, 129 of whom were available for NAS assessment.
MEASUREMENTS: Generalized linear modeling was performed using maternal and infant characteristics to predict: peak NAS score prior to treatment, whether an infant required NAS treatment, length of NAS treatment and total dose of morphine required for treatment of NAS symptoms.
FINDINGS: Of the sample, 53% (68 infants) required treatment for NAS. Lower maternal weight at delivery, later estimated gestational age (EGA), maternal use of selective serotonin re-uptake inhibitors (SSRIs), vaginal delivery and higher infant birthweight predicted higher peak NAS scores. Higher infant birthweight and greater maternal nicotine use at delivery predicted receipt of NAS treatment for infants. Maternal use of SSRIs, higher nicotine use and fewer days of study medication received also predicted total dose of medication required to treat NAS symptoms. No variables predicted length of treatment for NAS.
CONCLUSIONS: Maternal weight at delivery, estimated gestational age, infant birthweight, delivery type, maternal nicotine use and days of maternal study medication received and the use of psychotropic medications in pregnancy may play a role in the expression of neonatal abstinence syndrome severity in infants exposed to either methadone or buprenorphine.
Authors:
Karol Kaltenbach; Amber M Holbrook; Mara G Coyle; Sarah H Heil; Amy L Salisbury; Susan M Stine; Peter R Martin; Hendrée E Jones
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Publication Detail:
Type:  Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  Addiction (Abingdon, England)     Volume:  107 Suppl 1     ISSN:  1360-0443     ISO Abbreviation:  Addiction     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2012-10-30     Completed Date:  2013-10-22     Revised Date:  2014-05-16    
Medline Journal Info:
Nlm Unique ID:  9304118     Medline TA:  Addiction     Country:  England    
Other Details:
Languages:  eng     Pagination:  45-52     Citation Subset:  IM    
Copyright Information:
© 2012 The Authors, Addiction © 2012 Society for the Study of Addiction.
Data Bank Information
Bank Name/Acc. No.:
ClinicalTrials.gov/NCT00271219
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Analgesics, Opioid / administration & dosage,  adverse effects*
Birth Weight / physiology
Buprenorphine / adverse effects*
Dose-Response Relationship, Drug
Female
Humans
Infant, Newborn
Length of Stay
Linear Models
Methadone / adverse effects*
Morphine / administration & dosage
Neonatal Abstinence Syndrome / diagnosis,  drug therapy,  epidemiology*
Opioid-Related Disorders / drug therapy*,  rehabilitation
Pregnancy
Pregnancy Complications / drug therapy,  rehabilitation
Prenatal Exposure Delayed Effects / diagnosis,  drug therapy,  epidemiology*
Risk Factors
Serotonin Uptake Inhibitors / adverse effects,  therapeutic use
Severity of Illness Index
Smoking / epidemiology
Young Adult
Grant Support
ID/Acronym/Agency:
M01 RR 00095/RR/NCRR NIH HHS; M01 RR 109/RR/NCRR NIH HHS; M01 RR000095/RR/NCRR NIH HHS; M01 RR000109/RR/NCRR NIH HHS; R01 DA 015738/DA/NIDA NIH HHS; R01 DA 015741/DA/NIDA NIH HHS; R01 DA 015764/DA/NIDA NIH HHS; R01 DA 015778/DA/NIDA NIH HHS; R01 DA 017513/DA/NIDA NIH HHS; R01 DA 018410/DA/NIDA NIH HHS; R01 DA 018417/DA/NIDA NIH HHS; R01 DA 15832/DA/NIDA NIH HHS; R01 DA015764/DA/NIDA NIH HHS
Chemical
Reg. No./Substance:
0/Analgesics, Opioid; 0/Serotonin Uptake Inhibitors; 40D3SCR4GZ/Buprenorphine; 76I7G6D29C/Morphine; UC6VBE7V1Z/Methadone

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