Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Article
  • Published:

Analysis of the factors that influence the Finnegan Neonatal Abstinence Scoring System

Abstract

Objective:

To evaluate factors that can influence the Finnegan Neonatal Abstinence Score (FNAS).

Study design:

Retrospective analysis of 367 patients admitted to two level IV neonatal intensive care units. Linear mixed effects models were developed to evaluate daily census, time of the day, and day of the week as fixed effect predictors. The degree of influence that nurses had on FNAS variability was also estimated.

Results:

Bivariate analyses showed that daily census and the time of day have significant influence on the FNAS in institution 1, with minimal clinical significance. The proportion of variation in the FNAS attributable to differences in nurses was of 9.8% and 5.1% for institutions 1 and 2, respectively (P<0.0001).

Conclusions:

The minimal influences of extraneous factors on the FNAS support the clinical utility of the scoring system in the assessment and management of infants with Neonatal Abstinence Score.

This is a preview of subscription content, access via your institution

Access options

Buy this article

Prices may be subject to local taxes which are calculated during checkout

Figure 1

Similar content being viewed by others

References

  1. Hudak ML, Tan RC, Committee On D, Committee On F, Newborn, American Academy of P. Neonatal drug withdrawal. Pediatrics 2012; 129 (2): e540–e560.

    Article  Google Scholar 

  2. Finnegan LP, Kaltenbach K . Neonatal abstinence syndrome. In: Hoekelman RA FS, Nelson NM (eds). Primary Pediatric Care, 2nd edn. Mosby: St. Louis, 1992, pp 1367–1378.

    Google Scholar 

  3. Finnegan LP, Connaughton JF Jr., Kron RE, Emich JP . Neonatal abstinence syndrome: assessment and management. Addict Dis 1975; 2 (1-2): 141–158.

    CAS  PubMed  Google Scholar 

  4. Finnegan LP, Kron RE, Connaughton JF, Emich JP . Assessment and treatment of abstinence in the infant of the drug-dependent mother. Int J Clin Pharmacol Biopharm 1975; 12 (1-2): 19–32.

    CAS  PubMed  Google Scholar 

  5. Jones HE, Fielder A . Neonatal abstinence syndrome: historical perspective, current focus, future directions. Prev Med 2015; 80: 12–17.

    Article  Google Scholar 

  6. Desai RJ, Huybrechts KF, Hernandez-Diaz S, Mogun H, Patorno E, Kaltenbach K et al. Exposure to prescription opioid analgesics in utero and risk of neonatal abstinence syndrome: population based cohort study. BMJ 2015; 350: h2102.

    Article  Google Scholar 

  7. Jones HE, Harrow C, O'Grady KE, Crocetti M, Jansson LM, Kaltenbach K . Neonatal abstinence scores in opioid-exposed and nonexposed neonates: a blinded comparison. J Opioid Manag 2010; 6 (6): 409–413.

    Article  Google Scholar 

  8. Hoegerman G, Wilson CA, Thurmond E, Schnoll SH . Drug-exposed neonates. West J Med 1990; 152 (5): 559–564.

    CAS  PubMed  PubMed Central  Google Scholar 

  9. Patrick SW, Schumacher RE, Benneyworth BD, Krans EE, McAllister JM, Davis MM . Neonatal abstinence syndrome and associated health care expenditures: United States, 2000-2009. JAMA 2012; 307 (18): 1934–1940.

    Article  CAS  Google Scholar 

  10. Kaltenbach K, Jones HE . Neonatal abstinence syndrome: presentation and treatment considerations. J Addict Med 2016; 10: 224–228.

    Article  Google Scholar 

  11. Davies H, Gilbert R, Johnson K, Petersen I, Nazareth I, O'Donnell M et al. Neonatal drug withdrawal syndrome: cross-country comparison using hospital administrative data in England, the USA, Western Australia and Ontario, Canada. Arch Dis Child Fetal Neonatal Ed 2016; 101 (1): 26–30.

    Article  Google Scholar 

  12. Turner SD, Gomes T, Camacho X, Yao Z, Guttmann A, Mamdani MM et al. Neonatal opioid withdrawal and antenatal opioid prescribing. CMAJ Open 2015; 3 (1): E55–E61.

    Article  Google Scholar 

  13. Tolia VN, Patrick SW, Bennett MM, Murthy K, Sousa J, Smith PB et al. Increasing incidence of the neonatal abstinence syndrome in U.S. neonatal ICUs. N Engl J Med 2015; 372 (22): 2118–2126.

    Article  Google Scholar 

  14. Zimmermann-Baer U, Notzli U, Rentsch K, Bucher HU . Finnegan neonatal abstinence scoring system: normal values for first 3 days and weeks 5-6 in non-addicted infants. Addiction 2010; 105 (3): 524–528.

    Article  Google Scholar 

  15. Bagley SM, Wachman EM, Holland E, Brogly SB . Review of the assessment and management of neonatal abstinence syndrome. Addict Sci Clin Pract 2014; 9 (1): 19.

    Article  Google Scholar 

  16. Jones HE, Seashore C, Johnson E, Horton E, O'Grady KE, Andringa K et al. Psychometric assessment of the Neonatal Abstinence Scoring System and the MOTHER NAS Scale. Am J Addict 2016; 25 (5): 370–373.

    Article  Google Scholar 

  17. Orlando S . An overview of clinical tools used to assess neonatal abstinence syndrome. J Perinat Neonatal Nurs 2014; 28 (3): 212–219.

    Article  Google Scholar 

  18. Lucas K, Knobel RB . Implementing practice guidelines and education to improve care of infants with neonatal abstinence syndrome. Adv Neonatal Care 2012; 12 (1): 40–45.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to E Gomez-Pomar.

Ethics declarations

Competing interests

The authors declare no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Gomez-Pomar, E., Christian, A., Devlin, L. et al. Analysis of the factors that influence the Finnegan Neonatal Abstinence Scoring System. J Perinatol 37, 814–817 (2017). https://doi.org/10.1038/jp.2017.40

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/jp.2017.40

This article is cited by

Search

Quick links