Clinical and demographic predictors of the need for pharmacotherapy in neonatal abstinence syndrome

ObjectiveDevelopment and validation of a clinical prediction model for receipt of pharmacotherapy for Neonatal Abstinence Syndrome (NAS).Study designData from three cohorts included in- utero opioid exposed neonates ≥37 weeks gestation. Primary outcome was the receipt of pharmacotherapy utilizing a...

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Main Authors: Shawana Bibi, Rachana Singh, Janis L. Breeze, Jason Nelson, Walter K. Kraft, Jonathan M. Davis
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-08-01
Series:Frontiers in Pediatrics
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Online Access:https://www.frontiersin.org/articles/10.3389/fped.2025.1527276/full
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author Shawana Bibi
Shawana Bibi
Rachana Singh
Janis L. Breeze
Jason Nelson
Walter K. Kraft
Jonathan M. Davis
Jonathan M. Davis
author_facet Shawana Bibi
Shawana Bibi
Rachana Singh
Janis L. Breeze
Jason Nelson
Walter K. Kraft
Jonathan M. Davis
Jonathan M. Davis
author_sort Shawana Bibi
collection DOAJ
description ObjectiveDevelopment and validation of a clinical prediction model for receipt of pharmacotherapy for Neonatal Abstinence Syndrome (NAS).Study designData from three cohorts included in- utero opioid exposed neonates ≥37 weeks gestation. Primary outcome was the receipt of pharmacotherapy utilizing a modified Finnegan Neonatal Abstinence Scoring System (FNASS). A stepwise multivariable logistic regression model was built and internally validated.ResultsOf 698 infants included, 430 received pharmacotherapy. The final model included seven predictors of receipt of pharmacotherapy: gestational age, exposure to maternal breast milk, type of maternal opioid medication, and exposure to heroin, cocaine, benzodiazepines, and/or antipsychotic medications. The model had an AUROC of 0.68 (95% CI: 0.64–0.72; optimism corrected 0.65).ConclusionOur prediction model was parsimonious and identified seven predictors associated with the need for PT. Larger cohort studies are needed to more definitively establish risk of significant NAS requiring pharmacotherapy.
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spelling doaj-art-bdfcab80989343789b304342fa13b6d32025-08-20T03:59:45ZengFrontiers Media S.A.Frontiers in Pediatrics2296-23602025-08-011310.3389/fped.2025.15272761527276Clinical and demographic predictors of the need for pharmacotherapy in neonatal abstinence syndromeShawana Bibi0Shawana Bibi1Rachana Singh2Janis L. Breeze3Jason Nelson4Walter K. Kraft5Jonathan M. Davis6Jonathan M. Davis7Tufts Clinical and Translational Science Institute, Boston, MA, United StatesCleveland Clinic Children’s Hospital, Case Western Reserve University Lerner College of Medicine, Cleveland, OH, United StatesDepartment of Pediatrics, Tufts University School of Medicine, Boston, MA, United StatesTufts Clinical and Translational Science Institute, Boston, MA, United StatesTufts Clinical and Translational Science Institute, Boston, MA, United StatesDepartment of Pharmacology and Experimental Therapeutics, Thomas Jefferson University, Philadelphia, PA, United StatesTufts Clinical and Translational Science Institute, Boston, MA, United StatesDepartment of Pediatrics, Tufts University School of Medicine, Boston, MA, United StatesObjectiveDevelopment and validation of a clinical prediction model for receipt of pharmacotherapy for Neonatal Abstinence Syndrome (NAS).Study designData from three cohorts included in- utero opioid exposed neonates ≥37 weeks gestation. Primary outcome was the receipt of pharmacotherapy utilizing a modified Finnegan Neonatal Abstinence Scoring System (FNASS). A stepwise multivariable logistic regression model was built and internally validated.ResultsOf 698 infants included, 430 received pharmacotherapy. The final model included seven predictors of receipt of pharmacotherapy: gestational age, exposure to maternal breast milk, type of maternal opioid medication, and exposure to heroin, cocaine, benzodiazepines, and/or antipsychotic medications. The model had an AUROC of 0.68 (95% CI: 0.64–0.72; optimism corrected 0.65).ConclusionOur prediction model was parsimonious and identified seven predictors associated with the need for PT. Larger cohort studies are needed to more definitively establish risk of significant NAS requiring pharmacotherapy.https://www.frontiersin.org/articles/10.3389/fped.2025.1527276/fullneonatalabstinence syndromepredictorsclinicalpharmacotherapy
spellingShingle Shawana Bibi
Shawana Bibi
Rachana Singh
Janis L. Breeze
Jason Nelson
Walter K. Kraft
Jonathan M. Davis
Jonathan M. Davis
Clinical and demographic predictors of the need for pharmacotherapy in neonatal abstinence syndrome
Frontiers in Pediatrics
neonatal
abstinence syndrome
predictors
clinical
pharmacotherapy
title Clinical and demographic predictors of the need for pharmacotherapy in neonatal abstinence syndrome
title_full Clinical and demographic predictors of the need for pharmacotherapy in neonatal abstinence syndrome
title_fullStr Clinical and demographic predictors of the need for pharmacotherapy in neonatal abstinence syndrome
title_full_unstemmed Clinical and demographic predictors of the need for pharmacotherapy in neonatal abstinence syndrome
title_short Clinical and demographic predictors of the need for pharmacotherapy in neonatal abstinence syndrome
title_sort clinical and demographic predictors of the need for pharmacotherapy in neonatal abstinence syndrome
topic neonatal
abstinence syndrome
predictors
clinical
pharmacotherapy
url https://www.frontiersin.org/articles/10.3389/fped.2025.1527276/full
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