[Use of diazepam in the treatment of opioid neonatal abstinence syndrome].
BACKGROUND
The fetal opiate exposure presents many risks for the newborn. One of the most important is the neonatal abstinence syndrome that associates neurological and digestive signs. In some cases the vital prognosis can be involved. The evaluation of the syndrome's severity is based on certificated scales. The mortality has been reduced by the improved management of these neonates. Diamorphine, phenobarbital, chlorpromazine and diazepam are the most currently used. However, there is no consensus on the treatment. The data concerning the treatment are controversial, especially for the use of diazepam. The aim of our study was to describe the effects of diazepam obtained in three different centers and to compare our results to those of the literature.


METHODS
Twenty-three neonates were included. They were all hospitalized for abstinence syndrome and treated by diazepam. The Finnegan scale was used to evaluate the symptom's severity and the effects of the diazepam. The principal evaluation criteria were the duration of treatment and hospitalization, the timing in recovery of birth weight and the percentage of birth weight loss.


RESULTS
The average treatment duration was 7 days, the average hospitalization duration was 18 days, the birth weight was recovered at 10 days of life and the percentage of loss of birth weight was 6.5%. Diazepam treatment failed in only one case. No case of intense dehydration occurred.


CONCLUSIONS
Due to the retrospective design of the study, the diazepam could not be compared to other drugs. Nevertheless, it argues against the "anti-diazepam" attitude. A controlled randomised prospective study is needed to evaluated the optimal therapeutic strategy.
Autret
F
F
Service de néonatologie, hôpital d'enfants Armand-Trousseau, Assistance publique--Hôpitaux de Paris 26, avenue du Docteur-Arnold-Netter, 75571 Paris cedex 12, France.
Mucignat
V
V
De Montgolfier-Aubron
I
I
Blond
M-H
MH
Ducrocq
S
S
Lebas
F
F
Gold
F
F
D000328:Adult; D001724:Birth Weight; D003975:Diazepam / Q000627:therapeutic use*; D005260:Female; D018757:GABA Modulators / Q000627:therapeutic use*; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D009294:Narcotics / Q000009:adverse effects*; D009357:Neonatal Abstinence Syndrome / Q000188:drug therapy*; D011379:Prognosis; D012189:Retrospective Studies
D018757:GABA Modulators; D009294:Narcotics; D003975:Diazepam