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Short term outcomes of neonatal opioid withdrawal syndrome: a comparison of two approaches

Journal of Perinatology (2024)Cite this article

Subjects

Abstract

Objective

To evaluate outcomes in opioid exposed neonates (OENs) assessed by the Eat, Sleep, Console (ESC) tool compared to the Finnegan Neonatal Abstinence Scoring System (FNASS).

Methods

Retrospective analysis of a statewide database of OENs from 2017 to 2020 with birthing hospitals classified based on the assessment tool used. Four main outcomes were examined using multivariable and Poisson logistic regression models.

Results

Of 2375 OENs, 42.1% received pharmacotherapy (PT) with a consistent decrease in PT, length of treatment (LOT), and length of stay (LOS) over the study period. There was no change in use of mother’s own milk (MoM). While outcomes were significantly associated with several specific variables, there were no differences in outcomes between assessment methods.

Conclusion

While there was a significant decrease over time in PT, LOT, and LOS, improvements were independent of the assessment tool used and likely related to the increased use of non-pharmacologic care.

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Fig. 1: Trends over time for short-term outcomes for infants at risk for NOWS, a comparison between the three study groups.

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Data availability

The dataset used for this study is not publicly available as it contains some identifiable information, but is available from the corresponding author on reasonable request.

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Acknowledgements

The authors gratefully acknowledge the contributions of their subjects, and their subjects’ families, as well as those of their colleagues. PNQIN Perinatal Opioid Project Collaborating Hospitals: Baystate Medical Center, Springfield, MA, USA; Baystate Franklin Medical Center, Greenfield, MA, USA; Berkshire Medical Center, Pittsfield, MA, USA; Beth Israel Deaconess Medical Center, Boston, MA, USA; Beverly Hospital, Beverly, MA, USA; Boston Medical Center, Boston, MA, USA; Brockton Hospital, Brockton, MA, USA; Cape Cod Hospital, Hyannis, MA, USA; Cooley-Dickenson Hospital, Northampton, MA, USA; Lowell General Hospital, Lowell, MA, USA; Massachusetts General Hospital, Boston, MA, USA; MelroseWakefield Hospital, Melrose MA, USA; Mercy Medical Center, Springfield, MA, USA; Southcoast Health, Wareham, MA, USA; South Shore Hospital, South Weymouth, MA, USA; Tufts Medical Center, Boston, MA, USA; UMass Memorial Medical Center, Worcester, MA, USA.

Funding

This work has been supported by programmatic funding from Health Policy Commission of Massachusetts.

Author information

Authors and Affiliations

  1. Department of Pediatrics, Tufts University School of Medicine, Boston, MA, USA

    Rachana Singh, Jennifer Murzycki & Jonathan M. Davis

  2. Center for Applied Pediatric Quality Analytics, Boston Children’s Hospital, Boston, MA, USA

    Patrice Melvin

  3. Department of Pediatrics, Boston Medical Center, Boston, MA, USA

    Elisha M. Wachman

  4. Department of Pediatrics, Baystate Children’s Hospital, Springfield, MA, USA

    Robert Rothstein

  5. Divisions of Newborn Medicine and General Academic Pediatrics, Massachusetts General for Children, Boston, MA, USA

    Davida M. Schiff

  6. Division of Newborn Medicine, Baystate Franklin Medical Center, Greenfield, MA, USA

    Marcia VanVleet

  7. Division of Newborn Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA

    Munish Gupta

  8. The Tufts Clinical and Translational Science Institute, Boston, MA, USA

    Jonathan M. Davis

Authors
  1. Rachana Singh
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  2. Patrice Melvin
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  3. Elisha M. Wachman
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  4. Robert Rothstein
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  5. Davida M. Schiff
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  6. Jennifer Murzycki
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  7. Marcia VanVleet
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  8. Munish Gupta
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  9. Jonathan M. Davis
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Consortia

PNQIN Collaborative of Massachusetts

  • Rachana Singh
  • , Patrice Melvin
  • , Elisha M. Wachman
  • , Robert Rothstein
  • , Davida M. Schiff
  • , Jennifer Murzycki
  • , Marcia VanVleet
  • , Munish Gupta
  •  & Jonathan M. Davis

Contributions

RS and JD drafted the original manuscript and conceived and designed the study, contributed to data acquisition and analysis, and drafted the manuscript. PM contributed to data analysis; critically reviewed and revised the manuscript for intellectual content. EW, RR, DS, JM, MVV and MG contributed to data acquisition and analysis; critically reviewed and revised the manuscript for important intellectual content. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

Corresponding author

Correspondence to Rachana Singh.

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Competing interests

The authors declare no competing interests.

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Singh, R., Melvin, P., Wachman, E.M. et al. Short term outcomes of neonatal opioid withdrawal syndrome: a comparison of two approaches. J Perinatol (2024). https://doi.org/10.1038/s41372-024-01953-z

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