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CC BY-NC-ND 4.0 · Am J Perinatol 2024; 41(16): 2198-2205
DOI: 10.1055/s-0044-1786744
Original Article

Treatment for Neonatal Abstinence Syndrome Using Nonpharmacological Interventions

Tonya W. Robinson 
1   Department of Pediatrics, University of Louisville School of Medicine, Louisville, Kentucky
,
Reetta Stikes
2   Center for Women and Infants, University of Louisville Hospital, Louisville, Kentucky
,
Jaki Sorrell
2   Center for Women and Infants, University of Louisville Hospital, Louisville, Kentucky
,
Amanda Gater
2   Center for Women and Infants, University of Louisville Hospital, Louisville, Kentucky
,
Adam T. Booth
2   Center for Women and Infants, University of Louisville Hospital, Louisville, Kentucky
,
Amanda Gardner
2   Center for Women and Infants, University of Louisville Hospital, Louisville, Kentucky
,
Colleen Greenwell
2   Center for Women and Infants, University of Louisville Hospital, Louisville, Kentucky
,
Shannon Businger
2   Center for Women and Infants, University of Louisville Hospital, Louisville, Kentucky
,
Ryan Low
2   Center for Women and Infants, University of Louisville Hospital, Louisville, Kentucky
,
Rachael Petrie
2   Center for Women and Infants, University of Louisville Hospital, Louisville, Kentucky
› Author Affiliations Funding None.
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Abstract

Objective Management of neonatal abstinence syndrome includes nonpharmacological interventions, but their effectiveness may not be verified before implemented. The objective of this study is to evaluate the effectiveness of a type of bassinet in the treatment of infants with neonatal abstinence syndrome.

Study Design This is a retrospective observational cohort study. Study setting involved a 24-bed open-bay Level III neonatal intensive care unit located in a metropolitan academic trauma facility. Participant inclusion criteria involved prenatally opioid-exposed infants ≥ 35 weeks with confirmed maternal opioid urine toxicology, required pharmacological treatment for withdrawal symptoms, and were admitted to the neonatal intensive care unit. Three subsets of study participants were analyzed over three different time periods: Group 1 were infants admitted during 2019 without nonpharmacological intervention, Group 2 who were admitted from September 2021 to February 2022 and received nonpharmacological interventions, and Group 3 included those admitted from February 2022 to March 2023 who received the same interventions as Group 2 but were managed in bassinets being used in other local facilities for neonatal abstinence syndrome.

Results Group 3 had significant increases in length of stay compared with Group 1 (p = 0.006) and Group 2 (p = 0.013). Group 3 had a significantly greater length of treatment than Group 1 (p = 0.041) and a significantly higher total mg/kg morphine exposure than Group 1 (p = 0.006).

Conclusion Addition of the bassinet for nonpharmacological management of infants with neonatal abstinence syndrome appeared to prolong length of stay, length of treatment, and increase total mg/kg morphine exposure. As a retrospective nonrandomized study, weakness of low certainty of causality is of concern but findings strongly warrant further research before devices such as the bassinet used in this study are adopted for routine neonatal abstinence syndrome care.

Key Points

  • Special bassinets are promoted to enhance sleep and decrease agitation.

  • Such bassinets may assist infants undergoing drug withdrawal.

  • Study of the bassinet failed to show benefit to this population.

Keywords

withdrawal - addiction - opioids - neonate - bassinet

Ethical Approval

Institutional review board (IRB) and organizational approval were obtained for this study, IRB # 21.0555.




Publication History

Received: 08 March 2024

Accepted: 27 March 2024

Article published online:
10 May 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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