title: Skin conductance at baseline and postheel lance reflects sympathetic activation in neonatal opiate withdrawal.
abstract: OBJECTIVE
  Skin conductance (SC) provides an objective measure of autonomic system regulation through sympathetic-mediated filling of sweat glands. This study aimed to test the utility of SC to detect sympathetic activation in neonatal abstinence syndrome (NAS).
  
  
  METHODS
  Fourteen term (mean, SE: 38.8 ± 0.35 weeks gestational age) neonates with chronic prenatal opiate exposure were enrolled. SC (peaks/seconds and mean of peaks) was measured at baseline, during heel lance/squeeze (HLS) and recovery from HLS at 24-48 (mean 38) hours of life prior to treatment for NAS. Blinded coders with established reliability assessed neonates using the Modified Finnegan Neonatal Scoring System (MFNSS). Nonparametric tests were used to determine group differences, phase differences from baseline to HLS and HLS to recovery, and associations between MFNSS and SC measures.
  
  
  RESULTS
  Neonates that would later require morphine treatment for NAS (n = 6) had higher baseline SC mean of peaks than those that did not require treatment (n = 8) (p < 0.05). Moreover, there were unique phase differences between groups and SC positively correlated with MFNSS (p < 0.05).
  
  
  CONCLUSIONS
  SC provides early identification of NAS severity. However, a larger sample is needed to determine sensitivity and specificity of SC for early identification of NAS and treatment effectiveness.
authors.affiliation: Department of Pediatrics, College of Medicine, Penn State Hershey Children's Hospital, Pennsylvania State University, Hershey, PA, USA.
authors.forename: Christiana N
authors.initials: CN
authors.lastname: Oji-Mmuo
authors.affiliation: Department of Pediatrics, College of Medicine, Penn State Hershey Children's Hospital, Pennsylvania State University, Hershey, PA, USA.
authors.forename: Eric J
authors.initials: EJ
authors.lastname: Michael
authors.affiliation: Department of Obstetrics and Gynecology, North Shore University Hospital, Manhasset, NY, USA.
authors.forename: Jacqueline
authors.initials: J
authors.lastname: McLatchy
authors.affiliation: Department of Nursing, The M.S. Hershey Medical Center, Penn State Hershey Children's Hospital, Hershey, PA, USA.
authors.forename: Mary M
authors.initials: MM
authors.lastname: Lewis
authors.affiliation: Department of Nursing, The M.S. Hershey Medical Center, Penn State Hershey Children's Hospital, Hershey, PA, USA.
authors.forename: Julie E
authors.initials: JE
authors.lastname: Becker
authors.affiliation: Department of Pediatrics, College of Medicine, Penn State Hershey Children's Hospital, Pennsylvania State University, Hershey, PA, USA.
authors.forename: Kim Kopenhaver
authors.initials: KK
authors.lastname: Doheny
mesh_terms: D004553:Electric Conductivity; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D009293:Opioid-Related Disorders / Q000503:physiopathology*; D013375:Substance Withdrawal Syndrome / Q000503:physiopathology*; D013564:Sympathetic Nervous System / Q000503:physiopathology*
keywords: Infant-term; Neonatal abstinence; Neonatal drug withdrawal syndrome; Skin conductance; Sympathetic nervous system