„Neonatal Abstinence Syndrome"

Overview

Together with increasing occurrence of drug addiction in pregnant women in the Czech Republic also the incidence of neonatal drug withdrawal syndrome (neonatal abstinence syndrome, NA5) is probably rising. NA5 starts most commonly 48 - 72 hours after birth and exhibits CN5-associated (irritability, tremors and seizures - possibly life-threatening), GIT-associated (vomiting, diarrhoea, failure to thrive) and vegetative (sweatening, temperature instability) signs. Important for diagnosis of NA5 are the mother's history, mother's or baby's urine examination for presence of drug. The most sensitive laboratory test is the examination of meconium. It is advantageous to evaluate the clinical signs with aid of a clinical tool as Finnegan or Lipsitz score. Treatment of NA5 consists of gentle care, ensuring adequate caloric intake, sometimes with use of hypercaloric formulas, and, if indicated, early pharmacologic treatment. Babies, whose mothers are addicted to opioids, should be treated with tincture of opium, and phenobarbital is indicated in babies of mothers with other addictions. Pharmacological treatment relieves the signs of abstinence and then the dose is step by step lowered. 5igns of NA5 persist several days or weeks, sometimes even months. Long-term outcome of children after NA5 was not sufficiently studied but it seems that, with the exception of alcohol, the drug abuse in pregnancy does not significantly intluence the long-term development of surviving babies.

Key words:
drugs, addiction, pregnancy, newborn, signs of abstinence