Definitions of neonatal abstinence syndrome in clinical studies of mothers and infants: an expert literature review

• Published in: Journal of perinatology Vol. 41; no. 6; pp. 1364 - 1371
• Main Authors: Jilani, Shahla M., Jordan, Chloe J., Jansson, Lauren M., Davis, Jonathan M.
• Format: Journal Article
• Language: English
• Published: New York Nature Publishing Group US 01.06.2021; Nature Publishing Group
• Subjects: 692/1807; 706/648; Algorithms; Coding; Criteria; Drug withdrawal; Exposure; Female; Humans; Infant, Newborn; Infants; Literature reviews; Medicine; Medicine & Public Health; Mother and infant; Mothers; Narcotics; Neonatal abstinence syndrome; Neonatal Abstinence Syndrome - diagnosis; Neonatal Abstinence Syndrome - epidemiology; Neonates; Newborn babies; Opioids; Pediatric research; Pediatric Surgery; Pediatrics; Public health; United States
• ISSN: 0743-8346; 1476-5543; 1476-5543
• DOI: 10.1038/s41372-020-00893-8

Neonatal abstinence syndrome (NAS) results from discontinuation of in utero exposures to opioids/substances. The rising incidence of NAS has prompted an increased need for accurate research and public health data. To examine how NAS has been defined in clinical studies of opioid-exposed mothers and infants, a review process was developed based on the RAND/UCLA Appropriateness Method, yielding 888 abstracts. Per inclusion criteria, 57 abstracts underwent full-text review. To define NAS, studies cited using modified versions of the Finnegan NAS scoring tool ( n  = 21; 37%), ICD-9/10 coding ( n  = 17; 30%), original Finnegan tool ( n  = 16; 28%), Eat Sleep Console ( n  = 3; 5%), and Lipsitz ( n  = 3; 5%) tools, (3 cited 2+ tools). Most studies utilized subjective NAS scoring/assessment algorithms and neonatal coding as key elements defining NAS. While most cited opioid exposure as integral to their inclusion criteria, 26% did not. These approaches highlight the need for a more refined and standardized definition of NAS.