Neonatal abstinence syndrome (NAS)

• infants born to heroin-dependent or methadone-dependent mothers have a high incidence of neonatal abstinence reaction (also less potent opioids have also been identified as causing neonatal abstinence syndrome (NAS))
  • possible clinical features of NAS are non-specific and include tremor, unrest, tachypnoea, hypertonicity, vomiting, abnormal crying, yawning, sneezing, diarrhoea, fever, poor feeding - in very severe cases of NAS convulsions may occur
  • onset of clinical NAS symptoms depends on which opioids the pregnant opioid-dependent woman received or consumed
    • for example
      • heroin, the withdrawal syndrome in the neonate occurs during the first 24 h
      • with methadone NAS does not develop until after 48 h
      • opiates are the preferred initial therapy for NAS, especially for infants of mothers using opioids during pregnancy

Reference

1. Grossman M. Neonatal abstinence syndrome. Semin Perinatol. 2019 Apr;43(3):173-186.