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Development of an abbreviated symptom score for the neonatal abstinence syndrome

Abstract

Objective

We sought a shortened MOTHER neonatal abstinence syndrome (NAS) and Finnegan score that would retain comparable performance characteristics of the full instrument.

Study design

Retrospective cohort.

Results

In total, 124,170 MOTHER NAS scores between August 2007 and May 2016 from 775 infants (≥36 weeks) were examined. Classification and regression tree model identified the most important subsets of the scored variables. A 9-element shortened scale yielded >90% sensitivity and specificity to predict clinical endpoints based on the full 19-element MOTHER NAS score. Conversion of the data sets to the Finnegan score, and applying the same procedure resulted in a nine-element score with similar performance characteristics.

Conclusion

Shortened scoring instruments were identified with the high-predictive power for clinical endpoints based on the 19-element full MOTHER NAS score. There was no substantial variation in performance for age, supporting the current practice of utilizing a single scoring tool regardless of postnatal age.

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Fig. 1: Performance of the nine-element shortened MOTHER NAS scale (sMNAS-9) in the test set for postnatal weeks 1–5.
Fig. 2: Performance of the nine-element shorted Finnegan scale (sFNAS-9) in the test set for postnatal weeks 1–5.

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Acknowledgements

FB was supported by NIH grant T32GM008562. IC, SCAJ, and WKK are supported by NIH R03 HD098476-01.

Funding

This study was funded partially by NIH R03 HD098476-01.

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Correspondence to W. K. Kraft.

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The authors declare that they have no conflict of interest.

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Chervoneva, I., Adeniyi-Jones, S.C., Blanco, F. et al. Development of an abbreviated symptom score for the neonatal abstinence syndrome. J Perinatol 40, 1031–1040 (2020). https://doi.org/10.1038/s41372-020-0606-4

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