Identifying infants at risk for neonatal abstinence syndrome: a retrospective cohort comparison study of 3 screening approaches.
OBJECTIVE
The main objective of this study was to analyze the consistency in using a standardized newborn toxicology screening protocol to identify infants at risk of developing neonatal abstinence syndrome (NAS).


METHODS
A retrospective cohort comparison design was approved by the institutional review board at the regional hospital and used to gather data from the infants' medical records during the study period.


METHODS
The data were collected for a period of 1 year from a regional hospital serving 100,000 patients per annum.


METHODS
Data were based on expectant mothers who delivered between March 2006 and March 2007.


METHODS
Data of maternal self-reported substance use, and urine toxicology results and meconium results were obtained through retrospective chart review of infants exhibiting signs of NAS as noted by nurses on the Finnegan Scoring Tool.


RESULTS
In the absence of accurate prenatal screening, this study lends positively to support the use of toxicology screening protocols at birth to adequately assess and treat infants exposed to illicit substances. Toxicology screening in not intrusive and despite emotional discomfort experienced by mothers of the infants tested, the benefits of attaining accurate information regarding substance exposure is critical for the well-being of the infant.


CONCLUSIONS
The use of a toxicology screening protocol at birth appears beneficial in determining the need for identifying infants with NAS. Early detection of substance exposure in newborns leads to timely assessment for NAS and subsequent treatment to reduce symptoms in newborns.
Thunder Bay Regional Health Sciences Centre, Thunder Bay, Ontario, Canada. murphyj@tbh.net
Jodie
J
Murphy-Oikonen
William J
WJ
Montelpare
Sarah
S
Southon
Larry
L
Bertoldo
Nancy
N
Persichino
D000293:Adolescent; D000328:Adult; D002170:Canada / Q000453:epidemiology; D005260:Female; D006801:Humans; D013287:Illicit Drugs / Q000009:adverse effects; D007231:Infant, Newborn; D009294:Narcotics / Q000009:adverse effects; D009357:Neonatal Abstinence Syndrome / Q000175:diagnosis / Q000209:etiology / Q000378:metabolism / Q000628:therapy; D015997:Neonatal Screening / Q000379:methods; D011050:Policy Making; D011247:Pregnancy; D011248:Pregnancy Complications; D011297:Prenatal Exposure Delayed Effects; D012107:Research Design; D012189:Retrospective Studies; D015813:Substance Abuse Detection / Q000379:methods; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000378:metabolism
D013287:Illicit Drugs; D009294:Narcotics