TJC Safety Alert- Neonatal Abstinence Syndrome

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Managing neonatal abstinence syndrome Issue:

Neonatal Abstinence Syndrome (NAS) is a drug withdrawal syndrome experienced shortly after birth by infants who were exposed to opioids in utero. Symptoms of NAS include hyperirritability, excessive crying, poor sleep, poor feeding, diarrhea, hypertonia and tremors. Other symptoms include autonomic instability, poor sucking reflex, and in some cases, seizures.

This issue has grown substantially over the last decade, in part due to a surge in opiate usage (methadone, heroin, morphine, hydrocodone, and oxycodone) during pregnancy. NAS is no longer considered to be an issue only for infants born to mothers who used illicit drugs, as maternal pain prescriptions have increased. Heroin abuse has also increased, correlating to pregnant women with risky lifestyles, minimal prenatal care, and social, nutritional, physical and mental health problems. Between 2004 and 2013, NICU admissions increased almost threefold, with an increased length of stay from 13 to 19 days. Infants with NAS are more than twice as likely to be readmitted within 30 days after discharge due to drug withdrawal compared to uncomplicated term infants.

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