J P Chapman1, P Galea. 1. Royal Hospital for Sick Children, Yorkhill, Glasgow.
Abstract
OBJECTIVE: To get a clearer idea of the magnitude of the problem of Neonatal Abstinence Syndrome and, in particular, the number of cases and the severity and length of any withdrawal symptoms. DESIGN: Retrospective review of casenotes. SETTING: GRMH, Rottenrow Neonatal Unit Jan 1994-Aug. 1996. SUBJECTS: Infants admitted to the Neonatal Unit with the label "Infant of a Drug Abusing Mother" and their mothers. RESULTS: Sixty-four infants qualified for the audit i.e. on average two children per month. Most mothers had a polydrug habit taking both opiates and benzodiazepines. Thirty per cent of infants were premature and, as a group they were lighter and had a smaller OFC than the national average. Fifty-three infants suffered NEONATAL ABSTINENCE SYNDROME, 50 of these being "jittery, restless or irritable". Only four had convulsions. Most infants' withdrawal presented within 72 hours (median 24 hours) and lasted for less than six days. Infants exposed to methadone had symptoms for longer but required less treatment than infants exposed to heroin. Forty infants needed treatment with phenobarbitone for a median of four days. Only six infants needed other drugs. Median age of discharge was 11 days and 49 out of 53 went home with their mothers. CONCLUSIONS: The Glaswegian polydrug pattern would make morphine/methadone unsuitable treatment. If these infants are not showing signs of withdrawal at 72 hours it is, in our opinion, reasonable to discharge them. Infants should not be discharged with outstanding problems, as follow-up is usually unsuccessful.
OBJECTIVE: To get a clearer idea of the magnitude of the problem of Neonatal Abstinence Syndrome and, in particular, the number of cases and the severity and length of any withdrawal symptoms. DESIGN: Retrospective review of casenotes. SETTING: GRMH, Rottenrow Neonatal Unit Jan 1994-Aug. 1996. SUBJECTS:Infants admitted to the Neonatal Unit with the label "Infant of a Drug Abusing Mother" and their mothers. RESULTS: Sixty-four infants qualified for the audit i.e. on average two children per month. Most mothers had a polydrug habit taking both opiates and benzodiazepines. Thirty per cent of infants were premature and, as a group they were lighter and had a smaller OFC than the national average. Fifty-three infants suffered NEONATAL ABSTINENCE SYNDROME, 50 of these being "jittery, restless or irritable". Only four had convulsions. Most infants' withdrawal presented within 72 hours (median 24 hours) and lasted for less than six days. Infants exposed to methadone had symptoms for longer but required less treatment than infants exposed to heroin. Forty infants needed treatment with phenobarbitone for a median of four days. Only six infants needed other drugs. Median age of discharge was 11 days and 49 out of 53 went home with their mothers. CONCLUSIONS: The Glaswegian polydrug pattern would make morphine/methadone unsuitable treatment. If these infants are not showing signs of withdrawal at 72 hours it is, in our opinion, reasonable to discharge them. Infants should not be discharged with outstanding problems, as follow-up is usually unsuccessful.