Background and Aims Neonatal abstinence syndrome (NAS) often presents in the first 72 hours of life. Observation of at-risk infants is important to ensure prompt treatment if necessary. In 1998 at this hospital, 90% of infants requiring treatment for NAS commenced in the first week after birth. We aimed to describe the commencement of treatment for infants with NAS in the last decade.
Methods We undertook a retrospective review of babies treated pharmacologically for NAS during 2001–2010 at The Royal Women’s Hospital, Melbourne. Our guidelines recommend 7 days postnatal observation for infants at risk of NAS. Infants were admitted to the neonatal unit if they were felt to require treatment or had other neonatal complications.
Results 163 infants were treated for NAS; 85% and 8% of the mothers were hepatitis C and B positive respectively. In-utero substance exposure included opioids (97%), cannabis (29%) and benzodiazepines (25%). Over 90% of infants were treated by day 7 of life, most of whom had been admitted by day 5 (Figure). There were no differences in the age of treatment if the infant was exposed to opioids alone or multiple classes of drugs in utero.
Conclusion In the last decade, the timing of first medication for NAS is unchanged. Infants of chemically dependent mothers require a minimum of 7 days of in-patient observation.
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