open access

Vol 14, No 2 (2020)
Case report
Published online: 2020-05-16
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Neonatal abstinence syndrome in a newborn delivered by an opioid-dependent mother using methadone substitution therapy during pregnancy

Małgorzata Napieralska1, Iga Pawłowska2, Natalia Krzyzaniak3
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Palliat Med Pract 2020;14(2):124-126.
Affiliations
  1. Neonatology Unit, Regional Specialist Hospital W. Biegański in Grudziądz
  2. Medical University of Gdańsk, Department of Pharmacology
  3. Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Australia

open access

Vol 14, No 2 (2020)
Case report
Published online: 2020-05-16

Abstract

Introduction. Psychoactive substances as opioids used by women during pregnancy can have a negative
impact on the health of a newborn child.
Case report. Based on a case report of a newborn delivered by an opioid-dependent mother, this article
describes the therapeutic decision-making that occurred in caring for this patient. This included outlining
the form of substitution therapy selected and the use of Finnegan’s scoring system to assess the degree
of abstinence syndrome in the newborn.
Conclusion. There is a need to monitor drug-dependent women and their children from the early stages
of pregnancy through to birth to ensure positive health outcomes for both the mother and the newborn.

Abstract

Introduction. Psychoactive substances as opioids used by women during pregnancy can have a negative
impact on the health of a newborn child.
Case report. Based on a case report of a newborn delivered by an opioid-dependent mother, this article
describes the therapeutic decision-making that occurred in caring for this patient. This included outlining
the form of substitution therapy selected and the use of Finnegan’s scoring system to assess the degree
of abstinence syndrome in the newborn.
Conclusion. There is a need to monitor drug-dependent women and their children from the early stages
of pregnancy through to birth to ensure positive health outcomes for both the mother and the newborn.

Get Citation

Keywords

opioid, dependence, methadone maintenance treatment, neonatal abstinence syndrome

About this article
Title

Neonatal abstinence syndrome in a newborn delivered by an opioid-dependent mother using methadone substitution therapy during pregnancy

Journal

Palliative Medicine in Practice

Issue

Vol 14, No 2 (2020)

Article type

Case report

Pages

124-126

Published online

2020-05-16

Page views

601

Article views/downloads

915

DOI

10.5603/PMPI.2020.0012

Bibliographic record

Palliat Med Pract 2020;14(2):124-126.

Keywords

opioid
dependence
methadone maintenance treatment
neonatal abstinence syndrome

Authors

Małgorzata Napieralska
Iga Pawłowska
Natalia Krzyzaniak

References (11)
  1. Kocherlakota P. Neonatal Abstinence Syndrome. PEDIATRICS. 2014; 134(2): e547–e561.
  2. Patrick SW, Schumacher RE, Benneyworth BD, et al. Neonatal abstinence syndrome and associated health care expenditures: United States, 2000-2009. JAMA. 2012; 307(18): 1934–1940.
  3. World Health Organization. Operational guidelines for the management of opioid dependence in the South–East Asia Region, 2018. http://apps.who.int/iris/bitstream/10665/205591/1/B3229.pdf?ua=1 (11 March 2020).
  4. Lingford-Hughes AR, Welch S, Peters L, et al. British Association for Psychopharmacology, Expert Reviewers Group. BAP updated guidelines: evidence-based guidelines for the pharmacological management of substance abuse, harmful use, addiction and comorbidity: recommendations from BAP. J Psychopharmacol. 2012; 26(7): 899–952.
  5. Rostami-Hodjegan A, Wolff K, Hay AW, et al. Population pharmacokinetics of methadone in opiate users: characterization of time-dependent changes. Br J Clin Pharmacol. 1999; 48(1): 43–52.
  6. Logan BA, Brown MS, Hayes MJ. Neonatal abstinence syndrome: treatment and pediatric outcomes. Clin Obstet Gynecol. 2013; 56(1): 186–192.
  7. ACOG Committee on Health Care for Underserved Women, American Society of Addiction Medicine. ACOG Committee Opinion No. 524: Opioid abuse, dependence, and addiction in pregnancy. Obstet Gynecol. 2012; 119(5): 1070–1076.
  8. Müller MJ, Lange M, Paul T, et al. [Breast feeding during methadon- and buprenorphin therapy]. Klin Padiatr. 2011; 223(7): 408–413.
  9. Drozdick J, Berghella V, Hill M, et al. Methadone trough levels in pregnancy. Am J Obstet Gynecol. 2002; 187(5): 1184–1188.
  10. Wolff K, Boys A, Rostami-Hodjegan A, et al. Changes to methadone clearance during pregnancy. Eur J Clin Pharmacol. 2005; 61(10): 763–768.
  11. Women and Newborn Drug and Alcohol Service. Neonatal Abstinence Syndrome (NAS) Western Australia: King Edward Memorial Hospital. https://www.wnhs.health.wa.gov.au/~/media/Files/Hospitals/WNHS/Our%20Services/WANDAS/wnhs0197.pdf (11 March 2020).

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