Impact of a qualitative assessment approach for neonatal abstinence syndrome management: experience of a European reference center
Abstract Background The management of infants at risk of neonatal abstinence syndrome (NAS) remains challenging. In 2000 Maternidade Bissaya Barreto implemented a strategy based on the qualitative assessment of neonates and in 2018 the Eat, Sleep, Console (ESC) approach, a tool based on similar conc...
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BMC
2024-10-01
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| Series: | Italian Journal of Pediatrics |
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| Online Access: | https://doi.org/10.1186/s13052-024-01788-6 |
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| author | Mariana Cortez Ferreira Ana Moura Figueiredo Joaquim Pitorra Joana Mesquita da Silva |
| author_facet | Mariana Cortez Ferreira Ana Moura Figueiredo Joaquim Pitorra Joana Mesquita da Silva |
| author_sort | Mariana Cortez Ferreira |
| collection | DOAJ |
| description | Abstract Background The management of infants at risk of neonatal abstinence syndrome (NAS) remains challenging. In 2000 Maternidade Bissaya Barreto implemented a strategy based on the qualitative assessment of neonates and in 2018 the Eat, Sleep, Console (ESC) approach, a tool based on similar concepts, was created. The aim is to assess the efficacy of a qualitative assessment of infants at risk, compare it with the ESC approach and report temporal trends of NAS in a European hospital. Methods Retrospective cohort study of all infants of mothers with a history of drug abuse during pregnancy admitted to a tertiary European centre between January 2010 and December 2021. The therapeutical decision was guided by a qualitative assessment of the newborn’s well-being. The ESC approach was retrospectively determined. Pharmacologic treatment was used as a last resort. The clinical outcomes and therapeutic strategies employed were evaluated. Statistical association was evaluated. The incidence rate per 1000 births was calculated and temporal trend differences were identified. Results A total of 79 neonates at risk were included, of whom 40 (50.6%) developed NAS. Consolability was the most affected criterion (35.0%), followed by feeding difficulties (12.5%). Sleep was affected less frequently (5.0%). Overall, 37.5% of infants failed to meet at least one of the criteria. All neonates with a positive ESC failed the qualitative assessment (p = 1.000) After optimization of nonpharmacologic measures, drug therapy was still necessary in four cases (10.0% of infants with the syndrome). The incidence rate of NAS decreased from 3.9 per 1000 births in 2010 to 0.0 per 1000 births in 2021 (p = 0.025). Conclusion The qualitative assessment of the infant based on the ability to feed, sleep and be consoled correctly identified neonates at risk and led to a significant reduction in the use of drug therapy. The incidence rate of NAS decreased during the study period. |
| format | Article |
| id | doaj-art-1b11c5249d364de8a62a5e0fe89bbd69 |
| institution | OA Journals |
| issn | 1824-7288 |
| language | English |
| publishDate | 2024-10-01 |
| publisher | BMC |
| record_format | Article |
| series | Italian Journal of Pediatrics |
| spelling | doaj-art-1b11c5249d364de8a62a5e0fe89bbd692025-08-20T02:18:25ZengBMCItalian Journal of Pediatrics1824-72882024-10-015011910.1186/s13052-024-01788-6Impact of a qualitative assessment approach for neonatal abstinence syndrome management: experience of a European reference centerMariana Cortez Ferreira0Ana Moura Figueiredo1Joaquim Pitorra2Joana Mesquita da Silva3Neonatology Department, Maternidade Bissaya Barreto, Centro Hospitalar e Universitário de CoimbraNeonatology Department, Maternidade Bissaya Barreto, Centro Hospitalar e Universitário de CoimbraObstetrics Department, Maternidade Bissaya Barreto, Centro Hospitalar e Universitário de CoimbraNeonatology Department, Maternidade Bissaya Barreto, Centro Hospitalar e Universitário de CoimbraAbstract Background The management of infants at risk of neonatal abstinence syndrome (NAS) remains challenging. In 2000 Maternidade Bissaya Barreto implemented a strategy based on the qualitative assessment of neonates and in 2018 the Eat, Sleep, Console (ESC) approach, a tool based on similar concepts, was created. The aim is to assess the efficacy of a qualitative assessment of infants at risk, compare it with the ESC approach and report temporal trends of NAS in a European hospital. Methods Retrospective cohort study of all infants of mothers with a history of drug abuse during pregnancy admitted to a tertiary European centre between January 2010 and December 2021. The therapeutical decision was guided by a qualitative assessment of the newborn’s well-being. The ESC approach was retrospectively determined. Pharmacologic treatment was used as a last resort. The clinical outcomes and therapeutic strategies employed were evaluated. Statistical association was evaluated. The incidence rate per 1000 births was calculated and temporal trend differences were identified. Results A total of 79 neonates at risk were included, of whom 40 (50.6%) developed NAS. Consolability was the most affected criterion (35.0%), followed by feeding difficulties (12.5%). Sleep was affected less frequently (5.0%). Overall, 37.5% of infants failed to meet at least one of the criteria. All neonates with a positive ESC failed the qualitative assessment (p = 1.000) After optimization of nonpharmacologic measures, drug therapy was still necessary in four cases (10.0% of infants with the syndrome). The incidence rate of NAS decreased from 3.9 per 1000 births in 2010 to 0.0 per 1000 births in 2021 (p = 0.025). Conclusion The qualitative assessment of the infant based on the ability to feed, sleep and be consoled correctly identified neonates at risk and led to a significant reduction in the use of drug therapy. The incidence rate of NAS decreased during the study period.https://doi.org/10.1186/s13052-024-01788-6Neonatal abstinence syndromesNeonatal substance withdrawalNeonatesSubstance related disorder |
| spellingShingle | Mariana Cortez Ferreira Ana Moura Figueiredo Joaquim Pitorra Joana Mesquita da Silva Impact of a qualitative assessment approach for neonatal abstinence syndrome management: experience of a European reference center Italian Journal of Pediatrics Neonatal abstinence syndromes Neonatal substance withdrawal Neonates Substance related disorder |
| title | Impact of a qualitative assessment approach for neonatal abstinence syndrome management: experience of a European reference center |
| title_full | Impact of a qualitative assessment approach for neonatal abstinence syndrome management: experience of a European reference center |
| title_fullStr | Impact of a qualitative assessment approach for neonatal abstinence syndrome management: experience of a European reference center |
| title_full_unstemmed | Impact of a qualitative assessment approach for neonatal abstinence syndrome management: experience of a European reference center |
| title_short | Impact of a qualitative assessment approach for neonatal abstinence syndrome management: experience of a European reference center |
| title_sort | impact of a qualitative assessment approach for neonatal abstinence syndrome management experience of a european reference center |
| topic | Neonatal abstinence syndromes Neonatal substance withdrawal Neonates Substance related disorder |
| url | https://doi.org/10.1186/s13052-024-01788-6 |
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